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2. Jupiter Recreation Hospitality Vendor Registration
   Thank you for you interest in becoming a Jupiter Recreation Hospitality Vendor. Your application will be reviewed as soon as possible and we will contact you via email you provide on this application.
4. Step 1: Complete General Information
6. Company*
7. Doing Business As (DBA):*
9. Business Address:*
11. City*
12. State*
13. Zip*
15. Business Owner Name*
16. Website Address:
18. Phone*
19. Email*
21. Business Contact:
    If different from business owner.
22. Title:
24. Phone*
25. Email*
27. Check Services Provided*

    Please check all services your business provides:

    1. Accomodations
    2. Catering - Alcohol/Bar Service
    3. Catering - Food
    4. Catering - Mobile Vendor
    5. Catering - Other
    6. Event Planning/Decorating

    1. Event/Party Rentals - Equipment
    2. Event Staffing - Security
    3. Event Staffing - Valet
    4. Entertainment - Bands, DJ's, etc
    5. Florists

    1. Photography/Video
    2. Printing & Event Merchandising
    3. Production - Audio/Video
    4. Transportation - Limousine
    5. Transportation - Other
29. Breifly describe your business/services:*
33. Step 2: Upload Documents
    If available, please submit the below documents with this application or you may email it at a later date.
35. 1. Business Tax Registration (BTR)
    Please upload your current city, county or state registration.
36. Upload BTR/Registration
38. 2. Certificate of Insurance (COI)
    Please provide a Certificate of Insurance with the Town of Jupiter named as an additional insured and as a Certificate Holder with the address of 210 Military Trail, Jupiter, FL 33458.
    
    Current Comprehensive General Liability Policy: Of $1,000,000 is the requirement for proper limits.
    
    When applicable, minimum $1,000,000 products liability for all food vendors and/or liquor liability for beer and wine will apply. Certificate of Insurance must be signed by insurance company’s authorized representative.
39. Upload COI:
41. Insurance requirements are NOT applicable

    1. Applies to the business listed on this application.
    2. I am not sure
    3. Does not apply
43. Step 4: Release, Ideminty, and Waiver of Liability
    NOTICE: This permit contains a release, indemnity, and waiver of liability and when signed is a contract with legal consequences. Please read it carefully before signing your name.
    
    I have read the facility rental rules and understand them as they pertain to the activities of my group. I understand that I am responsible for the actions of my group and that noncompliance with any of the facility rental rules may result in revocation of this permit, loss of cleanup/security deposit, and/or other fees paid, and the denial of any subsequent permit applications for a period of at least one (1) year. I also understand that this is a public document that is open to public inspection and copying.
    
    TO TOWN OF JUPITER: In consideration of the opportunity afforded to me and/or my group, I, the undersigned participant, freely agree to and make the following contractual representations and agreements.
    
    I, the undersigned participant, do hereby knowingly, freely, and voluntarily assume all risk and liability for any damage or injury that may occur as a result of my and/or my group’s use of the facility identified herein during the time period I and/or my group are using same and further agree to release, waive, discharge, and covenant not to sue Town of Jupiter, its officers, agents, employees, and volunteers (all for the purposes herein referred to as “Releases”) from any and all liability or claims that may be sustained by me or a third party directly or indirectly in connection with, or arising out of, the use of the facility as described herein, whether caused in whole or in part by the negligence of the TOWN OF JUPITER or the Releases.
    
    I further agree to indemnify and hold harmless the Releases with respect to any and all fees, costs, expenses, and attorney’s fees arising out of or in connection with my and/or my group’s use of the park and/or facility as described herein.
    
    I agree that I have read this form, fully understand its terms, and understand that I, or anyone who may claim to have rights on my behalf, have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of any and all liability to the greatest extent allowed by law and agree that, if any portion of this contract is held to be invalid, the balance notwithstanding shall continue in full legal force and effect.
    
    This acceptance is on behalf of all persons in the group with me. If the rules are violated this permit may be revoked and future permission may be refused. Permit holder is responsible for the conduct of all persons in the group.
    
    I agree that I am 21 years of age or older and will be present during the period stated on this permit.
45. Electronic Signature:*
46. Date:*
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field