CARBON COUNTY FAIR
August 4-9, 2025
LARGE USER REGISTRATION FORM (No prepared food or candy) 
  
Please fill in all fields.  Upon completion, print, sign and mail to the payment address provided below.

Please type or print clearly   Please check (√ one)      ⁭Non-profit       ⁭Profit

Name of organization or business________________________________________

Contact person____________________________________________________

Street address_____________________________________________________

City/State_____________________________________  Zip code___________

Telephone_______________  Email address__________________________________

Items you will be displaying or selling____________________________________

Please indicate your electrical needs   ⁭   110     ⁭  220

ALL VENDORS SUBJECT TO APPROVAL BY VENDOR COMMITTEE.
Minimum size:  600 square foot.  This category must purchase 25 foot in depth, minimum.
1.  Total size of area requested ___ ft frontage  x ___ ft depth  = ___ sq ft  x $0.75/sq ft =		$ _______
2.  # vendor passes needed(15 supplied) Additional passes $3.50 each x ___ =  			$ _______
3.  Vendor Insurance, if supplied by CCLLFA insurance carrier @ $85.00			$ _______
Add lines 1, 2, and 3 and remit payment with registration form	       		             TOTAL 	$ _______

PAYMENT:  50% down by February 27, 2025.  Balance due by July 1, 2025.  Site will not be held
without payment.  All vendors must provide certificate of insurance, naming Carbon County
Fair or send additional $85.00 postmarked by July 1, 2025.  NO EXCEPTIONS!
Make checks payable to:	CCLLFA
			Bob Silliman, Vendor Chairperson
			250 Lentz Trail
			Jim Thorpe, PA 18229
NOTE:  Check or money order must accompany registration form.   Money order only after July 1, 2025.
         Questions, please call 570-657-7129.
All returned checks will be charged a $25.00 fee.  No refunds after June 1, 2025.

I agree to abide by all rules and regulations of the Carbon County Fair and accept all responsibility for my rented vendor space, product and/or services provided.  I further agree to hold Carbon County Fair, its' board of directors, officers and volunteers free from any and all liability.

Signature ________________________________________________________

FOR OFFICE USE ONLY
Initial Payment  $______    Check # ______    Date postmarked ______
Final Payment   $______    Check # ______    
⁭   Insurance certificate 		  Purchase Insurance   ⁭	    Sales Tax ID number __________________⁭     Additional passes ______
⁭   Approved by vendor committee	  Paid in full                    ⁭	    Packet mailed