2019 Picnic Online Registration Form35th ANNUAL VILLAGE OF BOLINGBROOK PICNIC - 2019Participation 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 CodePhone (Mobile)* Area Code - Phone Number Phone (Alternate) Area Code - Phone Number Organization Email (We would like to start sending application packages electronically, please provide an organization general mailbox for future years. )*1. What do you plan to do?*2. Size of space needed:*10x1010x1515x1515x203. Food Tent Needed?*YESNOIf yes, how many food tents needed?4. Tables Needed?*YESNONumber of Tables x $15 (each table includes 2 chairs):5. Electrical requirements (these need to be provided by the deadline date, limited availability):*YESNOA. 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):6. Do you plan on selling food and/or beverages, if so please provide the following information? (Don’t forget to fill out your Will County Health Department Form and send it in at least 10 days prior to event.) *YESNOIf 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, IL60440Submit Picnic FormReset