EclecTech Music Festival 2013 Registration Form

To insure we can meet your needs, this form should be completed by April 8th. Late entries may not be accepted. Other directions: 1. Please complete all sections of this form carefully. All communication for the needs of your entity need to be in writing. 2. Please specify setup details beyond those listed below on a separate form or diagram of your setup. (i.e. specific set up for power access, equipment layout, etc.) 3. All entities besides volunteers are required to provide a Certificate of Insurance to Indiana Tech. 4. Send an electronic copy of this form to Rebecca Daugherty to initiate your participation request. Just because you send the form does not mean it has been approved, we will send you an email confirmation once your space/time has been booked. A staff member will contact you 48 hours in advance of your event for any changes. Once the Contact Person approves a physical set-up, we will not have the ability to make any changes. Name of Organization/Band Contact Person: Website: Requested Start Time (Include am/pm): What time will the Contact Person be on site? (Include am/pm): Date Submitted: Phone: E-mail: Requested End Time (Include am/pm) Anticipated Number of Persons in Group: Audience/Participant Profile: What space(s) are you requesting for your organization? (mark all that apply): N.P. Standard Non-Electric ($0) Electric ($25) Band Booth ($0) Standard 10x5 Booth ($0) N.P. Double 20x5 Booth ($15) Band Booth with volunteer man it ($0) Farmers Market Standard Booth ($0) Farmers Market Electric ($25) Food Truck ($0) Volunteer Farmers Market Double Booth ($15) *N.P. signifies Non-Profit Bands/Vendors what items are you requesting for your space? (included in registration fee): Table Double Table Chairs Power Cord (please specify what you will be plugging in) Volunteers what times are you committed to work? (check all that apply): 10am-11am 7pm-8pm 11am-12pm 8pm-9pm 12pm-1pm 9pm-10pm 1pm-2pm 10pm-11pm 2pm-3pm 11pm-12am 3pm-4pm 4pm-5pm 5pm-6pm 6pm-7pm *Must work a minimum of 3 hours. All volunteers must wear t-shirt provided while working.

Bands, what equipment will you be bringing? Be specific. You will have 20 minutes in between sets to switch out instruments and to test the sound.

*Please note to keep on schedule, all bands will have 20 minutes to play and will share the 20 minutes in between to switch over and sound check. Fan favorites will have the chance to play again at 8pm for longer. Donations (Vendors/Organizations who donate will receive free booth space and will be included on sponsorship page and shirts: Please list your donation(s):

Vendors/Bands Requested Staffing: Help setting up Help tearing down Help running booth *All vendors and bands will register at the front table before loading. All vendors and bands will receive information before event about space and time assigned and will need to check in 1 hour prior to anticipated start time.

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T-shirts (please list the number of each size t-shirts requested for band members S: M: L: XL: Vendors/Organizations: If you would like to purchase and reserve event shirts, please list the number of sizes below: S: M: L: XL: Volunteers: What size shirt are you requesting?: S: M: L: XL: Event Venders: Will you be collecting money? Will you be handing out anything? What times do you anticipate being at the event? Are there any questions you have (someone will contact you)? *All vendors must have a certificate of insurance submitted 24 hours prior to the event. Contact Rebecca Daugherty, 800-937-2448 ext 2317 for forms. Department As Event Sponsor: If you are a department or entity of Indiana Tech, please fill out the information above and submit it to Rebecca Daugherty at RMDaugherty@indianatech.edu. No payment is required.

Total of Payment: __________________________________________ Signature of Contact Person/Volunteer __________________________________________ Signature of Event Coordinator (Rebecca Daugherty)

Please note: Special events are encouraged that contribute to both the academic environment and student development at Indiana Tech. Each event is a reflection of the Institute, regardless of who sponsors it. The lands and buildings of Indiana Tech are private property and the University reserves the right to control access to its campuses, and the use of its space and facilities. The purpose of this form is to ensure the University is represented in a professional manner, to strengthen outcomes, and to improve consistency. Compliance with all University policies and procedures must be maintained during the event. The University reserves the right to refuse or cancel any organization, vendor, band, or volunteer who does not meet these requirements.

Rebecca Daugherty (Student Life Coordinator) 800-937-2448 ext. 2317 or RMDaugherty@indianatech.edu

Please include this completed form as an attachment when submitting payment to RMDaugherty@indianatech.edu Before April 8th.

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