Juneteenth Festival Form

Please check vendor type: *

Non-Food Vendor
Food Vendor
Non-profit

Contact Name *

First

Last

Contact Number *

Business/Vendor Name *

Business Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Electricity Required? *

Electricity spaces are limited and reserved on a first come, first paid basis

Non-Food Vendor: Please check type of booth below:

Non-Food Vendor: What are you selling?

Please describe what you plan to sell

If you selected other, please list:

Photo Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Please upload photos of what you plan to sell.

NON-FOOD VENDOR please specify the type and number of spaces requested below *

Non-Food Vendor Space ($25)
Non-Profit Vendor Space
Choice 8

Please select all that apply

FOOD VENDOR please specify the type and number of spaces requested below *

Food Vendor Space ($100)
I AM NOT A FOOD VENDOR

Please select all that apply

Electric Connection

Flat fee for 30AMP ($25)
Flat Fee for 50AMP ($50)

Please select all that apply

FOOD VENDORS ONLY-please list main dish items and side items

FOOD VENDORS ONLY-please list name brand and model number of generator to be used

Applicant hereby certifies that all activities to be conducted in the booth(s) provided shall be lawful in all respects. In consideration of the space provided during the Bessemer City Juneteenth Festival, applicant does hereby acquit and forever discharge the City of Bessemer City, and Duke Power and their members, agents and employees, and all other persons, firms, corporations or partnerships of and from any and all claims, actions, causes of actions, demands, rights, damages, costs, loss of services, expenses and compensations whatsoever, which the undersigned applicant may have or which may hereafter accrue on account of or in any way growing out of any and all known and unknown, foreseen and unforeseen, bodily and personal injuries and property damage and the consequences thereof by applicant’s participation in the activity above. The undersigned has read the foregoing and fully understands it. Registration must be signed or it will not be processed. *

Agree

I agree that I must make payment to the City of Bessemer City (City Hall Annex, 125 East Virginia Avenue, Bessemer City, NC 28016) by cash, check or credit/debit card. after my application approval *

Agree

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