* 1. Restaurant Name (this will be used for your booth sign & collateral at the event):

* 2. The dish you will be preparing is:

* 3. The dish you will be preparing is:

* 4. Winery or Brewery you are paired with:

* 5. Beverage you will be pouring:

* 6. If you are pouring a wine, please let us know:

* 7. Do you want to be formally judged in the Culinary Competition?

* 8. Do you need electricity? (Only 110V is available)

* 9. What type of electrical equipment will you be using, if any? (Please remember no open flames allowed)

* 10. Have you submitted your health permit information to Placer County?

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