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* indicates required fields |
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Organization/Company Name *
(as it should appear in promotions & signage)
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Contact Name *
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Address:
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City:
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State:
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Zip/Postal Code:
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County:
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Cell Phone:
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Phone:
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Fax:
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Email Address:
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Website:
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Briefly describe the services your organization/company provides:
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Day of Event Contact & Exhibitor Space Info
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Day of Event Contact Name:
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Cell Phone:
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Email:
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What craft, activity, or give-away item will you bring for VIP kids? (this is a requirement)
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Number of Representatives attending:
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Electrical outlet needed?
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No Yes (no guarantee - there are limited # of booth locations to accommodate request) |
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Purpose(s) for Electricity:
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Water needed?
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No Yes (no guarantee - there are limited # of booth locations to accommodate request) |
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Purpose(s) for Water:
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Any other exhibit space requests? Please explain what and why it is needed. (All requests will be evaluated on a need basis. We will let you know if your request has been honored.)
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Check the ways you can help us spread the word about this event:
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8-1/2x11 Flyers - How many?
(indicate date needed)
5-1/2x8-1/2 Flyers - How many?
(indicate date needed)
11x17 Posters - How many?
(indicate date needed)
Email/Newsletter Announcement
(indicate deadline)
Other
(indicate date needed) |
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Registration Fee
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| The registration fee must be received before space can be confirmed. Fee includes the use of one sign, one 10x10 foot tent, one 6 foot table (not skirted or clothed), and two chairs. The registration deadline is Monday, May 3, 2010. |
| FEES BEFORE MONDAY, APRIL 5: |
Non-profit organization ($75)
For-profit organization ($150) |
| FEES AFTER MONDAY, APRIL 5: |
Non-profit organization ($100)
For-profit organization ($175) |
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Payment
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| Once you hit submit for this form, it will take you to a page where you can pay online by check or credit card. If you do not wish to pay online, it will also give you the mailing address so you can send a check and our phone number in case you’d like to process your credit card that way. |
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| By typing my information in below, I acknowledge the following: |
| IMAGE CONSENT: Film/video photography will be taking place before, during, and after Make 'm Smile on behalf of Nathaniel's Hope. I grant Nathaniel's Hope and any third party it may authorize, the right to photograph, make video and/or audio recordings of me and/or my representative(s) for use in or in connection with exhibitions, video, magazines, newspapers, internet or other publications or on television or radio. |
| WAIVER: As a representative of my company/organization, I agree to indemnify and hold harmless Nathaniel's Hope from all cost, expense or liability arising out of our participation as an exhibitor at this event. I do hereby waive all claims for damage or loss to me or my company/agency’s property which may be caused by any act, or failure to act, by Nathaniel's Hope, its officers, agents or employees from me or any representative of my company/organization. |
| TERMS: I have read the exhibitor information sheet and agree to the terms set forth by Nathaniel's Hope. If I will not be present at the event, I will communicate this information to the person(s) that will be representing me or my organization/company at the event. |
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Name *
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Company/Organization Name *
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