Bath Farmers' Market Application
2011 Season
Friday Evenings, May 20 - SEPT 30, 2011 3 - 7 pm
Keystone Park, Route 329, Bath, PA
Contact Information:
Business Name:__________________________________________________________________
Contact Name:___________________________________________________________________
Address:________________________________________________________________________
________________________________________________________________________________
Telephone / Fax:
Number:_________________________________________________________________________
Cell Phone Number:______________________________________________________________
E-Mail Address:
Prducts you Plan To Sell:________________________________________________
________________________________________________________________________________
Farm size:___________Acres in vegetables and herbs_______Acres in Fruit__________
Acres in meat/dairy:__________________ Acres in other crops:_____________________
Special Requirements: (sell from truck, etc.):
_________________________________________________________________________________
Payment Choice:
_____Half Season (May 20-July 22) @ 70
_____Half Season (July 29-Sept 30) @ $70
_____Full Season (May 20-Sept 30) @ $125
Fee is due by April 15, 2011. Make Checks payable to the Borough of Bath
Please Check if certified organic grower _____ Yes, _____ No
Please sign below, certifying that the information provided above is accurate and that you have read, understood and agree to abide by the Bath Farmers' Market Rules and Regulations including the completion of the Bath Borough Insurance and Indemnification Agreement for 2011. Return application to Fiona Adamsky, 4422 Maria Dr. Bethlehem PA 18020 (fiona07@verizon.net), as soon as possible to be included in pre-market publicity.
Signature _______________________________________________
Date __________________
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