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ENTRY FORM
Please print (Entry form must be received by November 12, 2007).
Name:______________________________________________________________________________________
Company:___________________________________________________________________________________
Mailing
Address:______________________________________________________________________________
City:___________________________________________ State:___________
Zip:______________
Phone: (Business):_____________________________
(Home):________________________________________
Description of items to be Sold:
__________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Number of 8' X 8' Spaces needed at a cost of $45.00 per space.________
Total enclosed $__________
Electricity needed:____________ Table needed:___________Other
needs:________________________________
Please make check payable to: UW Geological Museum.
I have read the attached information and agree, if accepted as an
exhibitor, to abide by all decisions and regulations of the 2007
Brontosaurus Holiday Bazaar. I agree to abide by all laws and ordinances
of the City of Laramie and Albany County. I agree to not hold
responsible The UW Geological Museum, Albany County Fairgrounds, or any
of the organizers, sponsors or co-sponsors of the "Brontosaurus Holiday
Bazaar" for any theft, loss or damage to my merchandise/property, or
bodily injury. I also give permission for the free use of my name and/or
picture in any account of this event.
Signature:___________________________________________
Date:_______________________________________________
Contact: Brent Breithaupt, Brontosaurus Holiday Bazaar, Geological
Museum, Dept. 3006, 1000 E. University Ave., Laramie, WY 82071. Please
direct any questions to: Brent Breithaupt, 307-766-2646 or
uwgeoms@uwyo.edu.
For Application Confirmation please send a self-addressed stamped
envelope.
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