VENDOR APPLICATION To Ensure Your Vendor Space Apply Before Friday, January 20, 2012 **

Panama City Mardi Gras Event Dates/Hours: February 3 - 6:00pm & February 4- 12:00pm- till Event location: McKenzie Park Downtown Panama City, Florida Please return application no later than Friday, January 20, 2012 Make check payable to:

Krewe of Massalina
P.O. Box 347 Panama City, FL 32404 Name: ___Hunter Smith_____________________________ Business Name: __Toadlick Music Festival___________________ Address: __PO Box 752_______________________________ City: __Dothan______________ State: __Al______ Zip: __36302_ Phone: _334-790-2954________ Fax: _334-792-2140____ E-Mail __hsmith@toadlick.com______________________ Resale Certificate # ________________________________________ Product: Specialty Specifically describe the food or retail product(s) you propose to sell, including price points: Promotion giveaway t-shirts etc for festival **Please include photo of booth display** Applications are subject to approval. Only product(s) described above are allowable to be vended or vendor will be rejected from festival area and vendor fee forfeited. Payment must be made in the form of a check, cash, CREDIT/ DEBIT CARD or money order AT THE TIME YOU SUBMIT YOUR APPLICATION. If payment is received later than the deadline, a $25.00 late fee will be charged. All vendors are required to submit a clean-up deposit of $100. Providing your booth is clean, your deposit will be refunded by request. True Craft (Handmade Items ONLY) 10 wide x 12 deep_______# of booths x $65.00 = $________ Non-Profit Organizations (Must provide documentation) _______# of booths x $0.00 = $ ________ Retail (Resale items) booth size is 10 wide x 12 deep $________ Food booth size is 15 wide x 12 deep =$________ Specialty booth (pool, spa, outdoor room, etc.) =$_300.00_ Clean-up deposit -______# of booths x $200.00 ______ # of booths x $200.00 _______# of booths x$100.00 = True Craft /Non-Profit Retail Food

OFFICE USE ONLY: Booth #________________ Pd. $___300.00______ Deposit $_0.00_________ Check #__50.00 for parade

Total $__300.00_ Location desired (not guaranteed) {i.e. near food, near other vendor, away from music}: ___50x20 space needed also in parade with both vehicles extra $50.00 paid __________________________________

Vendor to provide all booth materials (tables, chairs, tents, etc.). We are only providing space, water and electricity. Vendor is required to keep booth area clean or a $100 cleaning fee will be assessed to vendor. Electricity will be provided to both food vendors and retail vendors.

**Vendors must supply a minimum of a 100 heavy-duty extension cord.** Sorry No 220 available
Will you use electricity? (110v) mark ( x ) yes ( ) no

**YOU MAY NOT SELL OR GIVE AWAY ANY PRODUCT OTHER THAN WHAT IS LISTED. SALE OR DISTRIBUTION OF ANY PRODUCT NOT LISTED IS GROUNDS FOR EJECTION FROM THE EVENT AND FORFEITURE OF ALL FEES AND DEPOSITS.**

I understand that by completing this Vendor form and paying fees, I agree to and expressly undertake to indemnify and save harmless the Krewe of Massalina, Inc., its directors, officers, members, employees, agents, successors and assigns from any and all losses, personal injury, or damages of any type incurred by me which result from or arise out of membership in the Krewe of Massalina, Inc., or participation in the activities of the Krewe of Massalina, Inc., whether said damages are caused by the negligence of Krewe of Massalina, Inc., its directors, officers, members, employees, agents, successors and assigns or otherwise

I have read, understand and agree to comply with the rules stated below.

________________________________ Signed by:

_________________ Date:

** WE NOW ACCEPT CREDIT CARDS AND DEBIT CARDS** Please call office at 850-913-8383 to use this service