Payment options:
Cheque/money order payable to: Cooroy Pomona Lions Club
Direct Deposit: Bendigo Bank BSB 633 000 A/C 1425 24503
(for all electronic payments via bank transfer, please use your name and reason for transfer as payment reference, ie. John Smith Markets)

Application form to be completed and cheque/money order or proof of direct deposit delivered to:

King of the Mountain
Market Stall Coordinator
PO Box 144
POMONA QLD 4568

Before completing this application please contact Heather Manders on 0411 114 077 or email markets@kingofthemoutain.com.au to determine stall availability and fees.

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**FOOD & BEVERAGES** **ARTS & CRAFTS** **VINTAGE & ANTIQUES**

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Application for King of the Mountain Stall Site Markets for Sunday 23rd July 2023

It is hereby agreed that if accepted by the King of the Mountain Committee the organisation/individual(s) listed below be licensed to occupy a site as directed by the King of the Mountain Committee in the Festival area to exhibit or conduct a stall.

Stall Details

Contact Information

Business / Stall Holder Name*

Name*

First

Last

Position in organisation

Phone*

Email address*

Street Address*

Apt, Suite, Bldg. (optional)

City*

State / Province / Region*

Postal / Zip Code*

Country*

Stall site information

Description of goods or products to be sold / exhibited*

Upload your Public Liability Certificate (required)

Copy of your Public Liability Certificate attached?*

Yes

Stall site size

Is power required?*

Yes

If power is required, please list equipment to be used, power consumption and if single or three phase

Agreed total site fee

Payment transferred*

Yes

Other notes, concerns or requests

WAIVER RELEASE AND INDEMNITY

1. All stall holders are to be set up by 8am for trade by 9am. All vehicles not required for selling of products are to be parked off site. All stalls holders can start pull down around 4pm and leave around 4.30pm with the guidance of an official Lions Club person.

2. In consideration of the acceptance of my application for stall site, I hereby agree to comply with all the rules and instructions as issued by the King of the Mountain Committee or its nominee.

3. For myself, my executors, administrators, heirs, next of kin, successor and assigns, waive and release any and all claims that I may have against the Events Committee, their officers, directors, members, volunteers, employees, agents, sponsors, The State of Queensland, Noosa Council, or any one or more of them, their executors, administrators, heirs, next of Kin, successors or assigns (“the releasees”) including any and all claims for damage caused by the negligence of any of them arising out of my Ground Space License, together with any costs including attorney’s fees that may be incurred as a result of any such claim either valid or not, and indemnify and hold harmless “the releasees” and each of them against any such claim that I or my guests or any one or more of my executors administrators, heirs, next of king, successors and assigns may have or assert and against any costs including attorneys fees with respect thereto.

4. I hereby acknowledge that I have sole responsibility for my personal and organizations possessions and equipment.

5. I understand that my licence fee is non-transferable and in the event that I am unable to attend a refund will not be issued.

6. I understand that it is my obligation to satisfy all Public Liability Insurance Requirements and attach a copy of certificate to the stall application.

I hereby agree to the above terms & conditions*

Yes

Verification

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King of the Mountain Market Stalls