National Night Out Vendor Interest Form

2. Event Details
   The City of Marysville will host a National Night Out event at Jennings Park from 5:30 to 7:30 p.m. on Tuesday, August 6. The Jennings Park program will include hot dogs, popsicles, Police and Fire, K-9 Demonstration and Neighborhood Watch information. The event at Jennings Park will have an opportunity for vendor participation.

   The City of Marysville will host a National Night Out event at Jennings Park from 5:30 to 7:30 p.m. on Tuesday, August 6. The Jennings Park program will include hot dogs, popsicles, Police and Fire, K-9 Demonstration and Neighborhood Watch information. The event at Jennings Park will have an opportunity for vendor participation.

4. Applications are due by Wednesday, July 24th. Vendors will be notified by Friday, July 26th if they are approved to partipcate at the event.

6. Guidelines
   - Vendors will set-up near the Jennings Barn. - All vendors must have a FREE safety activity that engages the participant. Complimentary take-away items are also permitted. The nature of this event is to get participants active and engaged with the vendors in safety related activities or education. (Not just picking up pamphlets.) - Vendors must be related to neighborhood safety, preparedness, or community engagement. - The event runs from 5:30 - 7:30 p.m. Set-up and take-down will be 30 minutes prior and immediately following the event.

   - Vendors will set-up near the Jennings Barn. - All vendors must have a FREE safety activity that engages the participant. Complimentary take-away items are also permitted. The nature of this event is to get participants active and engaged with the vendors in safety related activities or education. (Not just picking up pamphlets.) - Vendors must be related to neighborhood safety, preparedness, or community engagement. - The event runs from 5:30 - 7:30 p.m. Set-up and take-down will be 30 minutes prior and immediately following the event.

8. Name of Vendor/Organization

9. Primary Contact Person(s)

11. Daytime Phone Number

12. Day of Event Cell Phone

14. Email

16. Address1

18. City

19. State

20. Zip

22. Description of Vendor/Organization

    Please provide a brief overview of the services your organization provides.

24. Description of FREE safety activity.

    All vendors must have a free safety activity that engages the participants. Complimentary take-away items are also permitted. The nature of this event is to get participants active and engaged with the vendors in safety related activities or education. (Not just picking up pamphlets).

26. Participation Information
    I have read and understand the National Night Out guidelines as stated above. For and in consideration of the opportunity to participate in National Night Out I, as evidenced by my signature below, do hereby hold harmless, release, and waive all claims I may have against the National Night Out organizers: City of Marysville, its officials, employees, agents and any other person(s) involved for any and all injuries, losses, or damages suffered by me as a result of my participation. I accept full responsibility for the cost of treatment for any injury, losses or damages suffered.

    I have read and understand the National Night Out guidelines as stated above. For and in consideration of the opportunity to participate in National Night Out I, as evidenced by my signature below, do hereby hold harmless, release, and waive all claims I may have against the National Night Out organizers: City of Marysville, its officials, employees, agents and any other person(s) involved for any and all injuries, losses, or damages suffered by me as a result of my participation. I accept full responsibility for the cost of treatment for any injury, losses or damages suffered.

28. I grant the National Night Out Organizers: City of Marysville, its officials, employees, agents and any other person(s) the right to take photographs of me and my property in connection with the above-registered program. I authorize the National Night Out organizers: City of Marysville, its officials, employees, agents and any other person(s) to copyright, use and publish the same in print and/or electronically. I agree that the National Night Out organizer: City of Marysville, its officials, employees, agents and any other person(s) may use such photographs of me with or without my name for any lawful purpose, including for example such purposes as publicity, illustration, advertising and web content.

    I grant the National Night Out Organizers: City of Marysville, its officials, employees, agents and any other person(s) the right to take photographs of me and my property in connection with the above-registered program. I authorize the National Night Out organizers: City of Marysville, its officials, employees, agents and any other person(s) to copyright, use and publish the same in print and/or electronically. I agree that the National Night Out organizer: City of Marysville, its officials, employees, agents and any other person(s) may use such photographs of me with or without my name for any lawful purpose, including for example such purposes as publicity, illustration, advertising and web content.

30. I have read and understand the above statements.

    First and Last Name

31. Date

33. Questions?
    Contact Leah Tocco | ltocco@marysvillewa.gov | phone (360) 363-8091 | fax (360) 651-5033

    Contact Leah Tocco | ltocco@marysvillewa.gov | phone (360) 363-8091 | fax (360) 651-5033

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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

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