Registration of Stall

APPLICATION INFORMATION

EVENT DATES : 25th & 26th September 2020

NAME:

TRADING NAME:

GOODS TO BE SOLD:

NO ALCOHOL OR DRINKS TO BE SOLD BY STALL OPERATORS

ABN:

EMAIL:

MOBILE NUMBER:

WORK NUMBER:

POSTAL ADDRESS:

DETAILS

Please note that self- powered stalls will only be accepted e.g. generator

Please note if you are a Community Group there is no fee to have a stall but stall attendees must pay gate entry for each stall person.

Do you provide your own lighting?

Yes No

Do you provide your own power?

Yes No

Will gas be used?

Yes No

Are vehicles of any type apart of your display?

Yes No

Measurements of your Stall:

Do you currently hold a food permit from the Shire of Broome?

Yes No Not Applicable

If you answered NO to the Food Permit, you MUST complete the Temporary Food Premise)

PAYMENT

Stall Fee Cost: $150 per day (excl GST)

Rhythm & Ride Stall $ 150.00 AUD

Subtotal $ 0.00 AUD Tax $ 0.00 AUD Total $ 0.00 AUD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Please note: Places are limited, applications will be addressed on a first come first serve basis. A site will not be allocated unless all forms are completed and payment made by 14th of September 2020. Once your site is allocated, you will be notified of setup times and site location.