9th Annual Walk for Willa 5K Run/Walk

Vendor Form Application

Hello Vendors,

Thank you for your interest in being a vendor! We want your business/organization to be part of this exciting event!

This event will take place from 8 am -12 pm on Saturday, April 16, 2022, at Crest Lake Park| 201 S Glenwood Ave., Clearwater, Fl 33755.

For all businesses, if paying by check, please make checks payable to the Willa Carson Health and Wellness Center| 1108 N Martin Luther King Jr. Clearwater Fl 33755 or pay electronically via PayPal to Willa Carson Health and Wellness Center.

PayPal Link: https://www.paypal.com/donate/?hosted_button_id=EFQVFHDBSHS9U

$125 Food Trucks | $50 Non-Food Vendors | No Charge 501c3's

Vendors are to arrive at 7:30 am. All vendors will be provided a table and 2 chairs.

For more information contact Pastor Carlton Childs at upwithlifeministries@yahoo.com

Question Title

* 1. Name of Business/Non-Profit

Question Title

* 2. Check one:

Business

Non-profit

Question Title

* 3. Agency/Program Description

Question Title

* 4. Contact Person

Question Title

* 5. Address

Question Title

* 6. Phone Number

Question Title

* 7. Email Address

Question Title

* 8. Form of payment (There is no charge for Non-Profits):

Cash

Electronic Payment

N/A

Check #

Question Title

* 9. I agree to hold harmless, the Willa Carson Health and Wellness Center, its affiliates, lesses, and personnel from any liabilities and claims sustained by me, my company/non-profit while participating in the 9th Annual Walk for Willa.

Yes, I have read and acknowledge the above information and understand my responsibilities as a vendor for this event.

Question Title

* 10. I authorize the filming and photographing of myself/coworkers and understand that there is no compensation to me and my coworker for such.

Yes, I authorize.

No, I do not authorize.