Bridal Boutique Vendor ApplicationSunday, April 30th 12-4pmPlease note that we will be limiting the amount of vendors per category. Kindly complete this form and you will be contacted regarding acceptance and asked for payment at that time.Vendor InformationContact Name*Business Name*Email*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Website Please provide a brief description of the goods or services your company offers.*Any food vendors must be in full compliance with health department regulations and must have the proper permits required.Please upload proof of general liability insurance.To view our insurance requirements, please CLICK HERE.If you'd like to submit your application now and send proof of insurance later, please e-mail vtirelli-hallock@peconiclanding.org.Max. file size: 20 MB.Do you need electric?* Yes NoHow did you hear about our event?Vendor Agreement*There is a $250 registration fee per vendor. VENDORS MUST SUPPLY THEIR OWN TABLE AND LINEN. All applicants are subject to approval or rejection at the discretion of Peconic Landing. If your application is approved, you will asked for payment. Your spot is not guaranteed until payment is made. Thank you! I understand the above terms and conditions.Liability Waiver*Vendor agrees to indemnify, hold harmless and defend Peconic Landing at Southold, Inc. and its agents, employees, representatives, officers, directors, stockholders, members, managers and parent, subsidiary, affiliated and successor companies (individually or collectively, the “Indemnified Parties”) from and against any and all liability for loss, damage or expense for which the Indemnified Parties may be held liable by reason of injury or harm to any person or damage to any property of whatsoever kind or nature arising out of or in any manner connected with the Vendor’s operations at the Event, excepting any damage or loss caused by the negligence of the Indemnified Parties. I understand and agree.By typing your name below, you are signing this waiver electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.*Questions?If you have any additional comments or questions, please leave a note below or contact Valerie Tirelli-Hallock by e-mailing vtirelli-hallock@peconiclanding.org.Δ
