Special Event Vendor Application

1

Vendor Information

Vendor Information

Organization/Business Name

Contact Name

Address

City/Zip Code

Email Address

Phone Number

2

Organization Type

Organization Type

N/A

Commercial

Non-Profit

If Non-Proft, Non-Profit ID #

SAN CLEMENTE BUSINESS LICENSE

All vendors (including nonprofit organizations) must obtain a San Clemente Business License. The Office is located at City Hall, (910 Calle Negocio). Contact Business Licensing at 361-6166 or businesslicense@san-clemente.org. *Nonresidents please ask about our one-day event fee!

3

Do you have a valid San Clemente Business License?

Do you have a valid San Clemente Business License?

No

Yes

If yes, Business License #

4

Do you have a valid Seller's Permit?

Do you have a valid Seller's Permit?

No

Yes

If yes, Permit #

5

(Food/Beverage Vendors Only) Do you have a valid Orange County Health Permit?

(Food/Beverage Vendors Only) Do you have a valid Orange County Health Permit?

No

Yes

If yes, Permit #

6

Booth Type (All booth spaces are 10 ft x 10 ft)

Booth Type (All booth spaces are 10 ft x 10 ft)

Product Sales/Artisan/Merchandise Vendor

Information (no sales)

Food Truck

Food/Beverage Sales Booth (not food truck)

Other If other, type text here.

7

Booth Description (Please include items to be sold)

Booth Description (Please include items to be sold)

8

I will provide any equipment required for my booth operations. Equipment such as canopies, tables, and/or chairs will not be provided. If electricity is required, a generator or other power source is required. Electrical outlets are not available. On-site storage of items is not permitted. Equipment must be brought in and removed the day of the event.

Agree

RELEASE FROM LIABILITY AND INDEMNIFICATIONS
Photo/Video Release: I understand that at various times City representatives may photograph and/or video activities of City recreation programs, special events, and participants. By signing this form, I authorize the City of San Clemente to use or publish any photographs/videos taken of me or my child/children to promote classes on the City’s website and other internet publicity, and/or in future publications of City brochures and/or flyers.
Release and Waiver of Liability and Indemnity Agreement: The undersigned hereby releases the City of San Clemente and its officers, agents, and employees from all liability to the undersigned (and from any minor participants for whom the undersigned has the capacity to contract), thereby releasing, indemnifying, and holding harmless the City of San Clemente, its officers, agents, and employees from all liability to the undersigned (and said minors) for any loss or damage on account of physical, mental and emotional injury to the undersigned (of said minors) caused by negligence of the City of San Clemente, its officers, agents, and employees. The undersigned hereby assumes full responsibility for, and the risk of, physical, mental, and emotional injury due to the negligence of the City of San Clemente, its officers, agents, and employees. The undersigned recognizes for himself or herself, and any minors that the events and occurrences to which this release applies can be dangerous and as a result of signing below, the undersigned is accepting those risks for himself or herself, and for any minor participants for whom the undersigned can contract.
I, THE UNDERSIGNED, AM FAMILIAR WITH THE NATURE OF ACTIVITIES AND CERTIFY THAT I HAVE READ AND UNDERSTAND THIS WAIVER AND RELEASE AS IT APPLIES TO MYSELF AND TO ANY MINORS FOR WHOM I AM SIGNING.

9

Digital Signature

Digital Signature

Full Name

Date

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

Page 1 / 1