Vendor Information
Business Name
*
Contact Person
*
Phone Number
*
Email Address
*
Business License / Permit #
*
Product(s) Selling/Promoting
*
Have you already signed a Burtech Open Market waiver?
*
No - this is my first Burtech Open Market
Yes - I signed a waiver at a previous market
Vendor Acknowledgment
Vendor Signature
Clear
Date Signed
Printed Name
I have read and agree to the Waiver & Release of Liability above.
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