Saturday, June 20, 2015 Chadwick Lake Park

Saturday, June 20, 2015
Chadwick Lake Park Newburgh NY 12550
Set up 7:45am, Health fair runs 8:00 am - 12:30 pm.- If you are brining your own tent, you may
set up on Friday night 5:00pm -7:30 pm.
Health &Community Wellness Fair Application
Contact Name: _____________________________________________________
Business Name:_____________________________________________________
Address: ___________________________________________________________
Phone Number:_____________________________________________________
E-mail:_____________________________________________________________
Please give us a quick overview of what you plan on doing:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
____________________________________________________________________
Space Needed: (Fees are Non Refundable)
___One Table 2 chairs ($100) ___ Bringing Own Tent and Table
Non-Profit tables are free of charge-limited space. If non-profit please check______
Gold and Platinum Sponsors are free of charge
There is NO electricity in the health fair area.
Name (Please print): __________________________________________________
Signature:___________________________________________________________
Date: ___/___/___
Make checks payable to: Lap4Life Foundation
Mail checks to:
Lap4Life Foundation
54 North Plank Road
Newburgh NY 12550
Health Fair deadline is May 20, 2015
There is limited space under the large tent, please register early.
Parking is limited to one spot in upper lot for health fair vendor. Your name will be on a list at the Park Entrance
54 North Plank Road Newburgh, NY 12550
845.325.3685
www.lap4life.org