Saturday, June 20, 2015 Chadwick Lake Park Newburgh NY 12550 Set up 7:45am, Health fair runs 8:00 am - 12:30 pm.- If you are brining your own tent, you may set up on Friday night 5:00pm -7:30 pm. Health &Community Wellness Fair Application Contact Name: _____________________________________________________ Business Name:_____________________________________________________ Address: ___________________________________________________________ Phone Number:_____________________________________________________ E-mail:_____________________________________________________________ Please give us a quick overview of what you plan on doing: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ____________________________________________________________________ Space Needed: (Fees are Non Refundable) ___One Table 2 chairs ($100) ___ Bringing Own Tent and Table Non-Profit tables are free of charge-limited space. If non-profit please check______ Gold and Platinum Sponsors are free of charge There is NO electricity in the health fair area. Name (Please print): __________________________________________________ Signature:___________________________________________________________ Date: ___/___/___ Make checks payable to: Lap4Life Foundation Mail checks to: Lap4Life Foundation 54 North Plank Road Newburgh NY 12550 Health Fair deadline is May 20, 2015 There is limited space under the large tent, please register early. Parking is limited to one spot in upper lot for health fair vendor. Your name will be on a list at the Park Entrance 54 North Plank Road Newburgh, NY 12550 845.325.3685 www.lap4life.org