THE BUGGY FESTIVAL OF CHURCH POINT

Food Concessions Application Form

Name: ___________________________________________________________________________

Address: _________________________________________________________________________

City: State: Zip: ____________________________________________________________________

Contact Person: ___________________________________________________________________

Number of Booth Spaces _____________________

Phone Number ____________________________

Booth Space
$ 225.00 
Beverage
$50.00
Clean up deposit
$50.00
Electricity
$20.00
Camper Overnight fee With electricity
$15.00 per day ________. Days ________
(Sorry no sewage hook up)  
Total Amount Due
____________
(Money order or Cashiers check) Payable to Acadia St.Landry Medical Foundation

Will you need electricity? . Yes ________ No _________

What Voltage 110vac ________ 220vac__________

First choice set up Location ___________________________________________________________

Second choice set up location __________________________________________________________

What food items will you be serving? _____________________________________________________

Please return form to:
Acadia St Landry Medical Foundation
P.O. Box 693
Church Point La.70525-2233