RUSSELL AGRICULTURAL SOCIETY

Non Food Concession Application and Contract 2011

Name___________________________________________________________

Address_________________________________________________________

Postal Code_______________Telephone_____________Cell_______________

email address_____________________________________________________

Types of articles to be sold or displayed_________________________________

Requesting   2 chairs_______1 table_______

Curling Club—10 foot frontage  $75.00  ___________________

                Hydro   $20.00/plug     ___________________(120 volt)

                Total                     ___________________

Outdoor NonFood—10 foot frontage  $75.00   _________________

                     Hydro  $20.00/plug       _________________(120 volt)

                     Total                      _________________

It is mandatory to provide a copy of Liabiltiy Insurance Certificate to the Russell Agricultural Society

Liability insurance certificate enclosed  yes___  no___

I, _______________________________, agree to the previous page terms and conditions of this agreement, and will not hold the Russell Agricultural Society responsible for loss or damage of goods brought onto the grounds or building by myself or my representatives.  I agree to accept the space allotted to me.

Payment must accompany this signed contract or the contract will not be accepted.

Signature__________________________________________

Questions regarding this application should be directed to Beth Ruiter 613-445-5744.