Registration Form


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October 5th 2018 6:00pm-10:00pm (5:00pm VIP) Location: American Aviation Flight Academy 17076 Helicopter Drive, Brooksville Fl 34604

VENDOR INFORMATION Please type or print clearly:

Business Name: ___________________________________________________________________________ Contact Name: ____________________________________________________________________________ Complete Address:_________________________________________________________________________ Phone: ________________________________________ Cell: _____________________________________ Email: ___________________________________________________________________________________

PARTNERSHIP SELECTION METHOD OF PAYMENT

 VENDOR TYPE: ☐ Member ☐ Non-Member  VENDOR FEE: (1) 10’ x 10’ space # spaces: ___________ - your display MUST fit within the booth specifications. Additional booth fees will apply if larger than 10’x10’

 Check attached

Credit Card

*** Two

(2) Designated Driver tickets are included in Vendor price. Any additional tickets must be purchased in advance. No sharing of tickets.

Electricity is NOT available for this event



NON-FOOD VENDORS

Chamber Members: Non-Chamber Members:



$75 $100

FOOD VENDORS/TRUCKS

Chamber Members: Non-Chamber Members:

$125 $150

☐ Booth Description (all vendors must complete include menu/or description of goods sold): _____________________________________________________ _____________________________________________________ ☐ Size & type of set up: __________________________ ☐Trailer ☐Truck ☐ Other _________________________ ☐ I will provide my own generator

Credit Card #

CVV

Exp.

Billing Address Signature

Total: $$___________

Please return this form with payment to: Greater Hernando County Chamber of Commerce 15588 Aviation Loop Drive Brooksville, FL 34604 Phone: (352) 796-0697 / Fax: (352) 796-3704 www.hernandochamber.com

A portion of our proceeds benefit CETA, a 501C3 education foundation.