Contact Name *

First Name

Last Name

Booth Type *

Information ($100 / $80 with member disc.)

Arts and Crafts ($100 / $80 with member disc.)

Food ($350 / $300 with member disc.)

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Payment options *

I will submit payment by credit card.

I will submit payment by mail to P.O. Box 2126, Clanton, AL 35046

Agreement *

I have read the terms and conditions set forth in the application and guidelines. I agree to abide by them and such other rules and regulations as established by The Chilton County Chamber of Commerce. The undersigned does hereby and forever discharge the Peach Jam Jubilee, Chilton County Chamber of Commerce, City of Clanton, its agents, representatives, and employees of and from all manner of action, suits, damages, claims and demands whatsoever in law and equity from any loss or damage while in the possession or auspices of the event, namely the Peach Jam Jubilee.

I agree

I do not agree