FAIRFIELD AREA CHAMBER OF COMMERCE

MARCH 1, 2008

REGISTRATION FORM

Name: ________________________________________________________________________________

Address: ______________________________________________________________________________

City: __________________________________        State & Zip Code: _____________________________

Phone: ________________ Fax: # ____________________ Email: ________________________________

Type of Business:       Non-food business_________                        Food Retailer________

Sales Tax ID #: ________________________________ (Needed if merchandise will be sold at the Showcase)

I hereby request _________ (# of booths) totaling $______________ in the 2008 Fairfield Business Showcase to be used for the sole purpose of exhibiting and selling my products or services to the general public.  Booth spaces are 9 feet X 9 feet.  The spaces include (1) table, (2) chairs and table linens.

• Do you need table skirts            Yes_____    No ______
• Do you need electricity?  (Please bring your own extension cords)  Yes_____    No ______
• If so, do you have any special power requirements?
• Wireless Internet will be available.  Contact the Fairfield Arts Convention Center for details. p641.472.2000
• Needed for Advertising purposes: Value of Door Prize ________________________________

COSTS:  (Make checks payable to: Fairfield Area Chamber of Commerce)

Chamber Member Early Bird Information:
By February 4- $125 – Extra booths are $50 each
After February 4- $150 – Extra booths are $60 each

Non-Chamber Member Early Bird Information:
By February 4- $175 – Extra booths are $50 each
After February 4 - $200 – Extra booths are $125 each

PLEASE NOTE THE FOLLOWING INFORMATION:

• Registration is non-refundable
• Registration is not confirmed until payment has been received
• The Fairfield Area Chamber of Commerce and all their employees and volunteers, the Fairfield Business Showcase, Fairfield Arts and Convention Center and employees thereof are not responsible for theft, damage or accidents that may occur
• Vendors are liable for damaged tables, chairs, skirts, walls and floor
• During the Showcase, if you need assistance please contact the staff at the Chamber booth
• Any questions, please feel free to contact Nancy Morrissey at the Chamber

READ CAREFULLY AND SIGN:

I for myself, company, corporation, executors, administrators and assignees, do hereby release and discharge the Fairfield Area Chamber of Commerce and all their employees and volunteers, the Fairfield Business Showcase, Best Western Fairfield Inn, and all their employees for all claims of damages, demands, actions whatsoever in any manner arising or growing out of my participation in the 2008 Fairfield Business Showcase.  I have full knowledge of my responsibilities concerning my exhibit space and do understand that I am responsible for all happenings within the confines of my exhibit space as a result of use of my exhibit space. I agree to be responsible for any permits required by law (i.e. sales tax permit) and am responsible for insuring my own liability.

Authorized Signature______________________________Title________________________Date____________________

Fairfield Area Chamber of Commerce  ·  204 West Broadway  ·  Fairfield, Iowa 52556
p641.472.2111  ·  Fax: 641.472.6510  ·  nmorrissey@fairfieldiowa.com    ·  fairfieldiowa.com