Genola Town Celebration 2023 Business Name(Required) Name(Required) First Last Address(Required) Cell Phone(Required) Email(Required) Enter Email Confirm Email Items to be sold(Required) Electricity Needed:Set up will be from 9:00 AM - 10:00 AM. Please be prepared to stay until 3:00 PM Yes No *Payment must a company registration form and must be received no later than June 6th, 2023.*Payment must a company registration form and must be received no later than June 6th, 2023. Product Name $15.00 Booth Fee — Tents are not provided for any of the booths $10.00 Booth Fee — Age 14 - 18 $5.00 Booth Fee — Age 13 & Under Credit Card Processing FeesStripe processing fees are added to the total price you pay. Stripe fees are 2.9% +$0.3 Price: $0.00 Total Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name