Become a Vendor Business Name*Specialty of Business*Contact Name* First Last Phone*Email* What health screening and/or activities (if any) will you provide at your booth?*Please describe any kid/family type activity you will have available at your booth.*Do you need access to an electrical outlet?*YesNoDo you have any additional needs?*Please attach a copy of your Certificate of Liability for our records.*$25 Donation Each exhibitor is encouraged to have a health related activity, game, or prize for FamFest guests. This will encourage guests to visit your booth. Our theme for Fam Fest this year is public safety, if you would like to tie in with the public safety theme with your activity or prize. For just a $25 donation, your booth space including table and chairs, as well as lunch, are provided by Meridian.Payment Options*I will donate $25 with a credit card now.I will provide a $25 door prize the day of.Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name