JUNETEENTH Commemorating the Emmancipation of African Americans C E L E B R A T I O N

Twenty-Fifth Annual

June 14, 2019

Veterans Square

LIVE MUSIC | VENDORS | GIVE-A-WAYS

FOR MORE INFORMATION: CONTACT MAYOR OLIVE MCKEITHEN (724) 983 - 2711

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FRIDAY, JUNE 14, 2019ANNUAL “BLOCK PARTY”

3PM - 7PMSPECIAL GUEST:

Carvel Austin “DID YOU HEAR THAT PRODUCTIONS”

(Youngstown, OH)

Sourlife (Pittsburgh, PA)

JUNETEENTH CELEBRATION REGISTRATION FORM

Check List YOU MUST BRING YOUR OWN TABLES AND CHAIRS

MUST HAVE HEAVY DUTY CORDS ONLY 10X10 TENTS (NO LARGE TENTS)

MUST COMPLETE A TEMPORARY EATING & DRINKING APPLICATION (IF SELLING FOOD)

Organization Name: Address: Contact Person: Phone Number:

FEE SCHEDULE (Please check one)

Information booths = FREE

10x10 booth with NO electric outlet = $40.00

10x10 booth with electric outlets – no refrigerator = $45.00 # of outlets

10x10 booth with electric outlets & refrigerator = $50.00 # of outlets ITEMS TO BE SOLD: I UNDERSTAND THAT I AM RENTING THIS BOOTH AT MY OWN RISK AND RESPONSIBILITY AND I WILL NOT HOLD THE CITY OF FARRELL RESPONSIBLE FOR ANY THEFT, FOOD SPOILAGE, DAMAGE TO EQUIPMENT, OR OTHER DAMAGE TO THE PROPERTY I BRING TO MY BOOTH. I AM SOLELY RESPONSIBLE FOR OPERATING MY OWN BOOTH. ________________________________________ ___________________________ Signature of Organization Representative Date

PLEASE RETURN THIS FORM WITH CHECK PAYABLE TO CITY OF FARRELL, 500 ROEMER BLVD., FARRELL, PA 16121

“Together We Are Better” FRIDAY, JUNE 14, 2019

SATURDAY, JUNE 15, 2019 11:00AM UNTIL DUSK

VETERAN’S SQUARE – FARRELL, PA FEDERAL STREET

Between DARR & SPEARMAN AVENUES

OFFICE USE ONLY

Date Payment Received Amount Paid Check #