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Harpswell Festival Non-Profit Application Where: George J. Mitchell Field; Rt. 123 (former fuel depot)When: Sunday, July 23rd, 2006; rain or shine Time: 11:00 am– 9:00 pm Set-Up: 7:30 – 10:30 am Take Down: 5:00 – 6:00 pm Contact: Diane Moody (207) 833-6128; Rob McAleer (207) 833-5574 As a Non-profit organization participating in the Festival, we need you to complete this form and return it to: Harpswell Festival, Inc., P.O. Box 405, Harpswell, ME 04079. *We need a copy of liability insurance for this date. *** We also need you to understand there is no water at this site, and no tables, chairs, or tents will be available. There is limited electricity and you must have a heavy duty extension cord free of frays, splits, or damage of any kind. Thank you for your cooperation.********************************************************************** Contact Person: _____________________________________ Phone#______________ Organization Name: _______________________________________________________ City, State, Zip: __________________________________________________________ What type of activity are you planning to do? ___________________________________ ________________________________________________________________________ ________________________________________________________________________ Do you need electricity? Yes___ No___ What is your approximate set-up size? ____x____ I hereby certify that the information contained herein is true, and that we are the non-profit of record at this event, and that we will abide by all published rules of record, those herein and those in any future communications concerning this event. We agree to forever discharge and release Harpswell Festival, Inc., Town of Harpswell, their agents and representatives from all actions, suits and claims. Signature: ____________________________________________________ Date: __________________ |