October 19, 20242024 Merchant Application B.O.O.T. Member Business Name* Contact Name* First Last Email* Phone Number*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code I am a B.O.O.T. Member in Good Standing (Membership paid for the current year)* Agree Disagree I will provide Liability Insurance Certificate naming B.O.O.T. as “Additionally Insured”* Agree Disagree Upload a copy of insurance here or submit a hard copy with your ABC License Application.Max. file size: 192 MB.Merchant Agreement - Please Read Carefully!!!* My signature below acknowledges that I have read the attached event policies and agree to abide by them.The undersigned does hereby discharge, release, and hold harmless, our Volunteers, Representative Wineries and Food Vendors, Business Organization of Old Town (B.O.O.T.), City of Clovis and their employees from any and all manner of action, suits, damages, or claims whatsoever arising from any loss of damages or claims to the person or property of the undersigned and/or persons who are assisting. This contract is non-cancellable and non-transferable. There is a $25 fee for all returned checks. The Business Organization of Old Town has my permission to publish photographs or videos taken of me or my business during the Old Town Clovis Wine Walk for purposes related to the promotion of Old Town Clovis.Digital Signature* Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Upon submission of this application, you will receive a confirmation email that includes a link to pay the $100.00 Merchant Participation Fee. Your application is not considered complete until payment is submitted. If you do not receive this confirmation email, and you have checked your spam, please contact us at [email protected] for assistance.
