2020 Picnic Online Registration FormDEADLINE EXTENDED TO FRIDAY AT NOON 36th ANNUAL VILLAGE OF BOLINGBROOK Social Distancing PICNIC - 2020Participation Form (All Details in this section are Mandatory, in case of Emergency.) Organization or Non-Profit Name* Your Name* First Last Address:* Street AddressCityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState / Province / RegionPostal / Zip Code Phone (Mobile)* Area Code - Phone Number Phone (Alternate) Area Code - Phone Number Organization Email (We now send application packages electronically, please provide an organization general mailbox for future years. )* %43 - 1. What do you plan to do?% %44 - 2. Size of space needed:% %45 - 3. Food Tent Needed?% If yes, how many food tents needed? %47 - 4. Tables Needed?% Number of EXTRA Tables x $15 (each table includes 2 chairs)(every entry for this year will receive 1 FREE table and 2 FREE chairs): 5. Electrical requirements (these need to be provided by the deadline date, limited availability):*YESNO A. Number of 110v/20w electrical outlets required (must be answered to receive electric): B. What are outlets to be used for? C. Amount of amperage (not watts) you will be pulling (must be answered to receive electric): %54 - 6. Do you plan on selling food and/or beverages of your own, if so please provide the following information? (Booth Fee - $25 which includes 1 table and 2 chairs.) (Don’t forget to fill out your Will County Health Department Form and send it in at least 10 days prior to event.) (This question is not for running a Village sponsored booth. If your organization would like to help run a Village sponsored Food Booth, email your request to info@bbcca.org, first come first serve basis.)% If Yes, please provide item name and price. Item #1: Item #2: Item #3: Please make checks payable to:Village of BolingbrookApplications that require payment must mail check so that it is received by 6/25/19 or drop it off at Village Hall Executive Department: Attn: CCA - Picnic. Mail payment to:Village of BolingbrookCCA – Village Picnic375 W. Briarcliff Rd Bolingbrook, IL60440 Submit Picnic FormReset
