Name (as should appear on your name tag, if you have other names for name tags write them on the back.

Business Name

Address

City                                                                              State                                                    Zip

Phone (daytime)                                                                        E-mail address  

Items to be sold (clearly describe all types): _____________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Special considerations: (electricity, requests, etc.)_________________________________________________________

_______________________________________________________________________________________________

General release:  The undersigned does hereby and forever discharge Poplar Grove Foundation, Inc. of and from all manner of actions, suits, damages, claims and demands whatsoever in law or equity, from any loss or damage to the undersigned’s property while in the possession, supervision or auspices of the Plant & Garden Sale.

Applicant’s signature                                                                                                                  Date