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2. Musician/Band Name:*
4. Primary Contact:*
6. Street Address:*
8. City:*
9. State:*
10. Zip Code:*
12. Phone Number:*
13. Mobile Phone:*
15. Email Address:*
17. Website or Social Media Link:
19. Please list names of employees, partners or family members who will be performing at the market:*
21. What is your preferred method of communication?*

    1. E-mail
    2. Phone
22. List products/merchandise your band plans to sell.*

    (Please list all products, and be specific).

24. Tell us about your your band:*

    Please write a short biography/story (5 sentences), such as your mission, genre, history, etc. that we can place on the website/Facebook to promote your business.

26. Are you interested in participating special events?*

    1. Yes
    2. No
28. Please check the dates you would like to apply to participate in at the market below:*

    1. May 7
    2. May 14
    3. May 21
    4. May 28
    5. June 4
    6. June 11
    7. June 18
    8. June 25
    9. July 2
    10. July 9
    11. July 16
    12. July 23

    1. July 30
    2. August 6
    3. August 13
    4. August 20
    5. August 27
    6. September 3
    7. September 10
    8. September 17
    9. September 24
    10. October 1
    11. October 8
    12. October 15
30. Select each line item to which you agree; leave blank those to which you do not agree or (not applicable to your farm or business):*

    1. I have read and understand the 2023 Vendor Rules & Guidelines and agree that I and my business employees will adhere to them, knowing that failure to do so may result in forfeiture of my space.
    2. The Portage Market will provide a table and tent for each musician the day of the performance & will be ready for you upon your arrival. Musicians are not required to tear-down the tent or a table.
    3. Musicians are expected to provide your own sound system and props. It will be the responsibility of the musician(s) to set up these items beforehand and take them down after the performance.
    4. My business has liability insurance for the Portage Farmers Market. I will provide a copy of my policy when my application is approved.
    5. My business does not have liability insurance for the Portage Farmers Market. I will sign a copy of the "Release of Liability" agreement below.
    6. I am willing to complete a vendor profile, provide anonymous sales data, and complete a year-end survey for evaluation purposes to provide valuable data and feedback for the market.
    7. I am willing to refrain from obscene or suggestive language/song content, discriminatory language/song content, and/or politically fueled language content as the Farmers Market is family friendly.
    8. I am willing to wear family-friendly attire, free of offensive or suggestive language.
    9. I am willing to provide a copy of my W-9 and Release of Liability to the City of Portage for the purposes of becoming a vendor and to receive payment if applicable for my services.
    10. I understand that if I do not show for my scheduled session, payment will not be issued.
    11. I understand that if I do not show for my scheduled session, payment will not be issued.
    12. I am also willing to refrain from handing out any literature or selling items that do not directly relate to my music.
    13. I understand that musicians are encouraged to hand out information about their music and/or performance schedule.
    14. I understand that musicians are expected to set up no later than 11 AM and are expected to play for two hours (11 AM - 1 PM).
32. I understand that the city will also list a link to my website/social media, I will be featured in the Portager Newsletter that is distributed to over 24,000 households in the City of Portage (if the application is received Prior to the printing deadline) and included in posts on Portage Farmers Market social media pages. If you Prefer to opt out of this free marketing program, please indicate “NO.”

    1. Yes
    2. No
36. Release of Liability

    I, the undersigned, consent to participate in the Portage Markets or being the parent or legal guardian of such a participant. In consideration of my or another’s participation in the Portage Markets hereby for myself, and any participant for who I am a parent or legal guardian, release, discharge, waive and hold harmless the City of Portage, its officers, agents, representatives and employees, from and against any and all liability, actions, causes of actions, claims known or unknown now existing or that may arise in the future arising out of or connected in any way from participation in the Portage Markets even though liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above.  I also hereby for myself or any participant for who I am a parent or legal guardian, waive, release and discharge any and all claims for damages for death, personal injury or property damage which may subsequently accrue as a result of participation in the Portage Markets.  I acknowledge that the City of Portage is not to be held responsible for damaged or lost items submitted as participation in the Portage Markets.

     I further understand and acknowledge that accidents may occur during an event or activity which may result in personal injuries and/or property damage as a consequence thereof.  Knowing the risks involved, I nevertheless, agree to assume those risks and to release and hold harmless all of those persons and entities mentioned above who, through negligence or carelessness, might otherwise be liable to me, or my heirs or assigns, for damages.

     I understand the hazards of the novel coronavirus (COVID-19) and its variants, and am familiar with the Centers for Disease Control (CDC) and prevention guidelines regarding this disease. I acknowledge and understand that the circumstances regarding this disease are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated and I accept full responsibility for familiarizing myself with the most recent updates. I will adhere to CDC guidelines, and regardless of the risks associated with COVID-19 and its variants, which I readily acknowledge, I hereby willingly choose to participate in the Portage Parks and Recreation activities. I fully assume the risk of illness or death related to this disease arising from my being on the premises and participating in the activities.

    It is further understood and agreed that this waiver of release is an assumption of risk and is to be binding on my heirs and assigns.

    I agree to be fully responsible for any injury or damage to any non-participant who may accompany me and hold the City, its officers, agents, representatives and employees harmless from any liability or actions which may result.

    I further agree to abide by and accept all of the rules conditions and regulations of the City of Portage, which are a condition of my participation in this program.

38. I have read and agree to the Release of Liability*

    1. Yes
    2. No
42. Publicity Release

    The City of Portage has my permission to use my or my child’s photo/image, voice or an item created by myself or my child including photos, drawings/illustrations, sculptures or other submitted item for promotional or educational purposes only including exhibition displays.  The City of Portage will receive the right to reproduce, at its own expense, images including, but limited to printed materials, online publications, news releases, videos, advertisements, media sites, website and social media outlets. I also provide permission for my name to be used in conjunction with the photos, videos or exhibition items for display, however in the case of a child under 18 years of age, only the first name and last initial will be used.  I also understand that no royalty, fee or other compensation shall become payable to me, or my child, by reason of such use.  I hereby release the City of Portage and its agents and assigns from any and any claims which may arise out of or are in any way connected with such use. If signing this Publicity Release form on behalf of a child (under 18 years of age), I certify that I am the parent or guardian of that child listed below. 

44. *The City will not release or publicize your address, phone or email. The information provided will be used for internal purposes only to contact you in regards to the publicity release.
46. I have read and agree to the Publicity Release*

    1. Yes
    2. No
50. Electronic Signature Agreement:

    By signing below, you certify that the information provided on this application is true and accurate and pledge that, as a musican of the Portage Farmers Market, you will abide by the 2023 Portage Farmers Market Rules and Guidelines.

    1. I agree.
52. Electronic Vendor Signature:*
53. Date:*
    Date:
55. Electronic Vendor Signature Agreement:*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 

    1. I agree.
59. For Portage Parks and Recreation Staff ONLY
61. Electronic Market Manager Signature
62. Date:
    Date:
64. Electronic Parks Director Signature
65. Date:
    Date:
Leave This Blank:


67. 1. Receive an email copy of this form.
68. Email address

    This field is not part of the form submission.

69. Submit Submit and Print

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