Kernersville Arts & Crafts Guild

Rock the Block

Saturday September 17, 2011 • 11 a.m. – 11 p.m. • 4th Street Downtown Winston-Salem

Non-Food Vendor Application Form

Booth Fee: $200
Business Name _____________________________________________________________________________________________
Contact Name ______________________________________________________________________________________________
Address ___________________________________________________________________________________________________
City, State, Zip ______________________________________________________________________________________________
Phone (Day and Evening) _____________________________________________________________________________________
E-mail Address _______________________________________________Fax__________________________________________
Items to be sold or displayed (name / price / description - use separate sheet if necessary) - Please provide a picture of items. Be
prepared to show proof of authenticity of licensed products.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
*You must provide your own table and chairs.
Are you bringing a tent?
Do you need access to electricity?
Voltage? ________
All completed applications, must be received by 5 p.m. on September 2.
HAND DELIVERY MAILING
City of Winston-Salem City of Winston-Salem
Marketing and Communications Marketing and Communications
101 N. Main Street (City Hall) P.O. Box 2511
Winston-Salem, NC 27101 Winston-Salem, NC 27102
336-747-7360 Attn: Rock the Block
I hereby acknowledge that if accepted to participate, I will comply with all rules, regulations and general information of Rock the Block, that Rock the Block reserves the right to
immediately evict from the event, without refund, any vendor for inappropriately displaying, broadcasting or selling anything deemed to be disrupting or harmful to the event and that I am
responsible to provide my own employees to assist me in running my vendor operations. I agree to release the City of Winston-Salem, The Downtown Winston-Salem Partnership and
any festival representative from any and all liability regarding any theft, damage, loss or claim that results, directly or indirectly, from my participation as a vendor at this event. Further, I
agree to indemnify and hold harmless the City of Winston-Salem, The Downtown Winston-Salem Partnership and any festival representative for any damage, claim or loss, including but
not limited to reasonable attorney's fees, resulting, directly or indirectly, from my negligent or intentional acts or omissions.
Signature ___________________________________
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