Register for the Clarendon Farmers Market Please fill out this form to hold a place at the Clarendon Farmers Market. Depending on your operation, additional documentation may need be provided to the Clarendon Alliance before your space at the Market will be confirmed. Please print out the appropriate form or forms from the "Additional Required Information" page, and mail or fax the completed forms to the Clarendon Alliance. The mailing address and fax number are on the bottom of each form. Name of Applicant* Prefix First Last Suffix Farm or Business Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone*Please provide either a business phone number or a cell phone number, preferably both.Cell PhonePlease provide either a business phone number or a cell phone number, preferably both.Email* Enter Email Confirm Email What general category applies to your operation?*Local Food ProducerValue added food productsWhich Markets do you intend to participate in?*Please click in the selection box below and check all that apply. Spring Specialty Market, April 4-25 High Season, May 2-October 31 Holiday Market, November 7-December 19 What types of locally produced foods do you intend to sell at the Market?*Please click in the box below and then click on all the items you intend to sell at the Clarendon Farmers Market in 2012. Note that you can amend your list as the Market season progresses.Locally grown produceLocally raised meat, fish or eggsLocally produced milk, cheese or dairy productsLocally produced baked goodsHoneyCiderAcidified foods such as pickles or salsaJams, preserves, syrupsFlowers, plants or herbsDried flower arrangements, wreaths, soaps or oilsOtherDescription of your productPlease describe your product in the space below.Who will be your representatives at the Clarendon Farmers Market?*Please list the names of your representatives. Include name, cell phone, email and your relationship (family member, employee) of the people who will represent you at the Clarendon Farmers Market.Detailed Driving Directions to your farm or production location from ArlingtonTotal Acres in ProductionThe total of owned and leased landLeased AcreageYou will be required to provide a copy of the lease agreement prior to selling at the Clarendon Farmers MarketTotal greenhouse space in productionTotal greenhouse space leasedYou will be required to provide a copy of the greenhouse lease agreement prior to selling at the Clarendon Farmers MarketFarm or Business DescriptionPlease write a paragraph describing your farm or business so we can include it on the Clarendon Farmers Market website. We will post this information, along with your address, phone, email and website (if you have one). The purpose is to help you generate sales and make it possible for customers to contact you if they have a special request. There are good examples of farm descriptions on the Arlington Farmers Market website: www.arlingtonfarmersmarket.comAcknowledgements*I have read and commit to abide by the rules of the Clarendon Farmers Market.YesNoProducer Acknowledgement*I agree to sell only products that I, my family, or my employees have grown or produced on my property, or on property I lease. I will not re-sell any product purchased from a wholesale warehouse, a retailer, or any other grower or other third party. I understand that my failure to comply with this provision may result in my suspension or expulsion from the Clarendon Farmers Market.YesNoWaiver*I acknowledge full and complete responsibility for all activities conducted by me, my family, and/or my employees or agents during my term at the Clarendon Farmers Market, and I agree to save, defend, hold harmless and indemnify the Clarendon Alliance and all of its agents and employees from and against any and all claims, loss, damage, injury, costs (including court costs and attorney's fees) charge, liability or exposure, however caused, resulting from, arising out of, or in any way connected with my performance or non-performance of the agreement terms or its obligations under the rules of the Clarendon Farmers Market. I agree to maintain adequate liability insurance as required in the Market Rules, and to fulfill all obligations under the Clarendon Farmers Market Rules in force at the time I submit this application.YesNoAdditional questions or commentsIf you have any questions or comments, please make them here. We will respond in a follow-up email to you.