Please print and Mail in
Augusta County Fishing Expo & Flea Market
Mark the Date Saturday February 16th 2013
9am-5pm
1st Annual Fishing Flea Market and Expo
Booth/Vendor registration Form
Saturday February 16th 2013 9:00 AM – 5:00 PM
NAME:____________________________________________________
BUSINESS:_________________ _________________________________
MAILING ADDRESS:__________________________________________
__________________________________________________________
TELEPHONE:______________________CELL:______________________
EMAIL:____________________________________________________
WEB SITE OR BLOG:__________________________________________
Can you do a seminar? YES NO
If yes , Please provide your Topic:________________________________________________________________
One of the sport show Commtee officer will noify you if you been Approve to do a Seminar
Booths are 6’ X 5” with 1 table and 2 chairs. 2 exhibitor badges for all access.
Back Drop are welcome if you have your own.
Electricity is limited. First come first served.
Print names for exhibitor badges:
1.________________________________ 2._______________________________
Augusta County Bass Jon’s Release of Responsibility/ Photo Release
I hereby release, discharge and agree to hold harmless and indemnity the Augusta County Bass Jon’s, it’s officers, directors, the host and it’s partner demands action or right of action which are released to rise out of or missions of Augusta county bass Jon’s and all other person or entitles associated with the Fishing flea market and expo for any and all injury death illness or desease and other damage or loss property suffered by self or other in signing this document.
I acknowledge and agree that if anyone is hurt or property is damaged while I am engaged in this event I will have no right to make claim or file lawsuit against Augusta County Bass Jon’s.
And Augusta County Bass Jon’s it’s officer direct agents the host official and all other persons or
entities associated with the event even if they or any of them negligently cause the bodily injury or property damage.
Signature of vendor_____________________________________ Date________
Augusta County Bass Jon’s officer__________________________ Date________
Contact:
Doug Fitzgerald 540-910-0078
Eric Royer 540-470-7976
Darin Clements 434-989-0209
acbassjons@yahoo.com
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30 booths of tackle, fishing information, guides, advice, Fishing Pros, Food for sale (by America Legion ), activities for the kids, a Visit from Acbassjons “ Zoomie the lizard”, Smoky The Bear, 50/50 raffle Hooters Girls . Come out to support the kids fishing derby (held in June 2013) and theVerona area food Pantry. Booths are $20.00+Door Prizes
Booth space is limited
Will be held at
“American Legion”
357 Cedar Green Road
StauntonVA 24401
Please Mail the Vendor Registration To:
Augusta County Fishing Expo
Att Doug Fitzgerald
1511 Jefferson Hwy
Fishersville VA 22939
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