Artspire 2024 Food Vendor Application Form - Pump House Regional Arts Center

Business Name*
Contact Name*
First Last
Phone*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website
Facebook Page
Instagram Page
Other Social Media
Driver's License No.*
Health Permit No.*
WI Tax Acct. No. or SSN or FEIN*
Menu Items/Food Description*
Describe your proposed menu.
Tent/Truck Description*
- Food Truck
- Cart
- Tent
- Other
Tent/Truck Dimensions*
Serving Window Location*
- Driver Side
- Passenger Side
- NA
Electrical Needs*
Watts, volts or amps AND plug type.
Other features and/or needs:
Digital Signature (See Agreement Below)*

AGREEMENT: As a participant, I hereby agree to hold harmless and indemnify Artspire La Crosse, Pump House Regional Arts Center, the City of La Crosse, and their officers, agents, representatives, volunteers and employees from and against any and all types of claims, demands, losses, liability, actions or expenses arising of any kind whatsoever which connect with participation in the celebration. I also agree to defend Artspire La Crosse, Pump House Regional Arts Center, the City of La Crosse, and their officers, agents, representatives, volunteers and employees against claims or actions by attendees. I further testify that I am authorized by the stated organization to give signature to this agreement.
Date*
MM slash DD slash YYYY

Save and Continue Later