2019 Registration Form CLICK HERE TO READ THE RULES, REGULATIONS & INSURANCE REQUIREMENTS BEFORE REGISTERING Brews on Lake Augusta Alcohol Vendor Registration Organization Name*The name of the organization your are registering. List it as you would like it to appear on the festival map and in any promotional materials.Organization Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Person (Primary)* First Last Contact Phone (Primary)*Contact Email (Primary)* Would you like to enter a secondary contact?*NoYesContact Person (Secondary) First Last Contact Phone (Secondary)Contact Email (Secondary) What type of vendor are you?*Please select one.BreweryWineryMeaderyDistilleryOtherDo you plan to SELL alcohol at the event?*NoYesAct 166 Documentation*Required per the State of PA if you wish to sell product at the event.Accepted file types: jpg, gif, png, pdf.Are you bringing a tent or a trailer?*Vendors must supply their own tent/trailer.TentTrailerWhat size space do you need?*10' x 10'10' x 20'otherWill you be bringing your own generator?*NoYesGenerator Make & Model*Please tell us what type of generator you have. Generator Noise Level*On a scale of 1-10, 1 being quiet enough to hear a pin drop, 10 being as loud as a plane taking off, please rate how loud your generator is.12345678910Do you need us to supply you with electricty?*NoYesHow many OUTLETS do you need (Standard 120V)?*Standard 120 VPlease enter a number from 1 to 10.How many OUTLETS do you need (240V - Limit 1)?240V outlets are limited to 1Please enter a number from 0 to 1.How long will it take to set up your space?*Please estimate how long it will take you to set up your vendor space.0-30 Minutes30-60 Minutes60+ MinutesAdditional notes to Brews on Lake Augusta event committee:Proof of InsuranceALL applicants are required to have insurance. Please review items 9 and 10 in the event rules and regulations for complete insurance requirements. If you have insurance documents available, please upload them to your registration (it makes things a lot easier and more efficient).Accepted file types: jpg, gif, png, pdf.Requirements, Rules & Regulations Acknowledgment* I have read, understand and agree to abide by the Requirements, Rules and Regulations associated with participating in 2019 Brews on Lake August Wine and Beer Festival.