Vendor's Name _________________________________________________________

Company Name _________________________________________________________

Address _________________________________________________________

City _______________________________

Postal Code _______________________________

Telephone _______________________________

Email _______________________________

List of Products

Market Days Requested

Hydro required

No. Stalls of requested 1

Agreement of Compliance

I, ___________________________________________ , have read and am fully aware of the

Burlington Lions Club’s Burlington Mall Farmers’ Market specific rules and

regulations.

I hereby agree to comply fully with these rules and regulations and all other Federal,

Provincial, Regional and local regulations that apply. Knowing full well that I will

forfeit my right to sell at the Burlington Nelson Lions Farmers’ Market if I am found to

be in non-compliance.