Exhibitor Application Form 2009 Connecticut Liberty Forum

Saturday October 17, 2009 from 8:00AM-5PM and

at the Sheraton Hotel – Bradley Airport, 1 Bradley International Airport, Windsor Locks, Connecticut 06096

Please fill out the entire form below and return with check as payment to NHELD and send to:

Judy Aron, 40 North Quaker Lane, West Hartford, CT 06119

Exhibitor Information

Company/Organization being represented __________________________________________________

Name of Contact Person ________________________________________________________________

Name(s) of Exhibitor(s) (if different) ______________________________________________________

Address of Contact Person_______________________________________________________________

Phone of Contact Person___________________Email of Contact Person __________________________

Items to be exhibited/sold (books, services, etc) _________________________________

If you have a website what is the web address? _______________________________________________

Tables are $50 each. Electricity is available but outlets are limited, first come first served.

Please note: If you need electricity you must also bring an adequate extension cord

Vendor set up time is 6:45am-7:45am on Saturday October 17 and break down time is from 5:00pm-6:00pm on Saturday October 17. Please indicate below the amount of table space you will need - table size is 6 feet long and skirting will be provided.

A confirmation will be sent to you via email. Any questions can be forwarded to Judy Aron 860-523-7257 or ctlibertyforum@nheld.com

I would like _____ table(s) at $50 each

I ( ) do not need electricity ( ) need electricity Total amount: $_______________

**** Checks should be made payable to National Home Education Legal Defense (NHELD) ***** IMPORTANT! You must sign the Hold Harmless Agreement below and please make sure that if you are selling anything that you allow for, and understand CT Sales Tax Rules and Regulations.

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Hold Harmless Agreement - Waiver and Release

In consideration for being permitted to sell, display, distribute or inform about material at the 2009 CT Liberty Forum

______________________________________________________________________ (Exhibitor Name)

agrees to assume full responsibility for, and hold The Sheraton – Bradley Airport (Starwood) and National Home Education Legal Defense, and any and all persons or entities affiliated with the above including, but not limited to, agents, representatives, employees, and volunteers, harmless from any and all legal liability, loss, theft, injury or damage to the person or property of the exhibitor or of any other person or entity in connection with the exhibitor's activities related to the CT Liberty Forum. Exhibitor acknowledges that the agent signing below is duly authorized to execute this instrument.

In addition, Exhibitor acknowledges that The Sheraton – Bradley Airport (Starwood) and National Home Education Legal Defense nor any of its officials and employees, maintain insurance covering Client’s property. It shall be the sole responsibility of Client to obtain property damage insurance covering any such losses by the Client.

________________________________________________ ___/___/___ (Signature of Agent and Date Signed)

______________________________________________________________(Agent's Title)

______________________________________________________________(Organization Name)

______________________________________________________________(Address)