Page 1 2015 Busker Application Formt Performer first name: Performer last name: Contact person (if applicable) : Mailing address: City: Province: Postal code: Home phone: Business phone: Cell phone: Email: Entertainment Classification: Website: Music Theatre Clowning Other Description of performance: The 124 Grand Market dates 2015 There is no cost for busking at the 124 Grand Market. All buskers must be approved by a Market Director to perform at the market. In order to best showcase an array of local talent and ensure a profit for all Buskers, a rotation and a time limits are imperative. Buskers will be scheduled to take breaks and possibly change locations during market day. Please indicate dates you would like to perform at the 124 Grand Market by circling the dates. 2015 outdoor season: Name of Busker applicants(s): Dates requesting to vend at the market: please check off M AY: 14 21 28 JUN: 04 11 18 25 JUL: 02 09 16 23 30 AU G : 06 13 20 27 S E P: 03 10 17 24 O C T: 01 08 Signature of Busker applicant(s) or Parent/Guardian for Children 12 and under: Vendor Waiver Page 2 Please initial each line for acceptance & understanding & submit with your signed application. The following Rules & Regulations for the 124 Grand Market operations will be explicitly implemented at all times. No exceptions. 124 Grand Market does not provide Liability Insurance for individual vendors. It is the vendor’s responsibility to have their own insurance, and we strongly encourage every vendor to carry their own Liability Insurance Policies. The Alberta Farmers’ In consideration of the opportunity to use 124 Grand Market and its facilities, provided for the duration of the market, operated by the 124 Grand Market Directors and Wild Heart Collective LTD. , its employees and volunteers, we the - under signed, hereby agree to the following: To waive any and all claims that we, __________________________________________________________________ Business (operating) name: _________________________________________________________________ employees, agents, representatives and volunteers. To release from any and all liability for any loss, damage, injury or expense that occurs out of the use of any of the facilities of the 124 Grand Market, Wild Heart Collective, 124 Street Business Association and the Board of Directors, by the above named Vendor, their family, their employees or volunteer participants. To hold harmless and indemnify the 124 Grand Market, Wild Heart Collective LTD., and 124 Street Business Association from any and all liability for any property damage, personal injury to any third party or other financial loss or expense, including legal expense and costs of a solicitor-and-his-own-client full indemnity basis, resulting from the participation in any event to be ran by or held on the facilities of the 124 Grand Market, Wild Heart Collective and the 124 Street Business Association throughout the 2015 season. We, the undersigned, hereby acknowledge that we have read the foregoing and understand its content, import and meaning. Participant’s Name (please print) Witness Name (please print) Participant’s Signature (on behalf of all participating vendors listed above) Witness Signature Date: Date: *The waiver must be returned signed by the vendor and a witness, with the application form or the application will not be accepted*