2. 

   Saturday, April 29, 2023 
   Dillon's Woods & Bush Tabernacle

   Purcellville, Virginia

   We invite local art organizations to participate in the 2023 Purcellville Music and Arts Festival to have a display and activity for families that visit the Art Hall from noon to 5 p.m. 

4. Name of Organization:*
6. Organization Address:*
8. City:*
9. State:*
10. Zip:*
12. Organization Mission Statement:*
14. Organization Website or Facebook Page:*
15. Name of Contact Person:*
17. Email Address:*
18. Phone Number:*
20. Please describe what you will have on display:*
22. Please describe what hands-on activity or art demonstration you will have at your table:*
24. How did you hear about the Purcellville Music & Arts Festival?*

    1. Email
    2. Facebook
    3. Press release
    4. Online calendar
    5. Print article
    6. Word of mouth
    7. Other (if other, please specify)
25. If selected other, please specify:
27. DETAILS OF PARTICIPATION FOR ART ORGANIZATIONS IN THE ART HALL:*

    You must check all boxes.

    1. There is no fee for local art non-profits to participate in the Art Hall.
    2. A table and chairs will be provided to each art organization inside the Bush Tabernacle.
    3. You will need to be able to load in and load out all of the items for your table/display - there won't be staff or volunteers available to help.
    4. Break down will be Saturday, April 29 from 5 to 6:30 p.m. A separate event is in the Bush Tabernacle that evening starting at 7 p.m. so everything must be out by 6:30 p.m.
    5. You must have your display staffed the entire time from noon to 5 p.m. on April 29.
    6. Additional details and confirmation will be emailed to art organizations before the festival.
29. AUTHORIZATION AND INDEMNIFICATION:*

    By checking the box below, the Entrant: (i) attests that he or she understands and shall comply with all of the guidelines and information provided on this Festival Application

    The Exhibitor/Entrant, by his authorized signature, hereby agrees to indemnify, hold harmless, and defend the Town of Purcellville, Virginia, its elected and appointed officials, employees, agents and successors in interest from all claims, damages, losses and expenses including attorneys’ fees, arising out of or resulting, directly or indirectly, from the Entrant’s participation in the Purcellville Music and Arts Festival, provided that such claim, damage, loss or expense is: (1) attributable to personal injury, bodily injury, sickness, death, or to injury or destruction of property, including the loss of use resulting there from, and (2) not caused by the grossly negligent act or omission, or willful misconduct of the Town of Purcellville, Virginia, its elected and appointed officials, or its employees acting within the scope of their employment. This Hold Harmless and Indemnification Clause shall in no way be limited by any financial responsibility or insurance requirements and shall survive the termination of this Entrant's Application Form. The Entrant understands that any misrepresentation in this application, deviation from the final approved specifications and activities described herein, or failure to abide by all Federal, State and Local laws, ordinances, policies and procedures may result in the immediate revocation of this approved Event Entrant's Permit and refusal to issue a permit in the future. The Exhibitor/Entrant, by his authorized signature below, hereby authorizes the Town and/or its designee(s) to take photographs, videotape, record, or produce communications for this and/or future events for publicity, promotion, and media coverage.

    1. I agree
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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