Senior Health & Resource Fair 2023

Business/Organization Name *

Primary Contact Name *

First

Last

Secondary Contact Name

First

Last

Phone *

Email *

Secondary Email

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Website / URL

Electricity Required? *

*Limited availability and electrical cords will not be provided.

Please Specify the Type of Table: *

6 ft Rectangle Table
Round Table
Other

*Please note (1) table and (2) chairs will be provided. Additional items including a bus or trailer please list in the space below.

Additional

How many people attending in group? *

Please list type of display, including information to be distributed and any give away items to be distributed: *

Applicant hereby certifies that all activities to be conducted in the exhibitor booth(s) provided shall be lawful in all respects. In consideration of the space provided during the Bessemer City Senior Health & Resource Fair, applicant does hereby acquit and forever discharge the City of Bessemer City, agents and employees, and all other persons, firms, corporations or partnerships of and from any and all claims, 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, forseen 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 *

Senior Health & Resource Fair 2023

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