Primary Sellers Name *

First Name

Last Name

Additional Sellers

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Please check all items to be sold (Vegetables):

Asparagus

Beans

Broccoli

Beets

Cabbage

Carrots

Cauliflower

Corn

Cucumber

Eggplant

Garlic

Kahlrabi

Lettuce

Onions

Peas

Peppers

Potato

Pumpkins

Radishes

Spinach

Squash

Zucchini

Tomato

Other

Please check all items to be sold (Fruits):

Apples

Blueberries

Currants

Elderberries

Gooseberries

Grapes

Melons

Pears

Plums

Apricots

Strawberries

Other

Please check all items to be sold (Specialty Products):

Baked Goods

Bread

Eggs

Jams

Jellies

Honey

Maple Syrup

Pickles

Flour/Grains

Meat (USDA Inspected)

Fruit Pies

Dairy

Other

Please check all items to be sold (Non-Food Products):

Annual Plants

Cut Fresh Flowers

Cut Dried Flowers

Gourds

Berry/Grape Plants

Perennial Plants

Vegetable Starts

Handmade Jewelry

Crafts

Potter

Soap

Candles

Other

I have read and agree to abide by the Lewiston Area Farmers Market By-Laws. *

Yes

No

I have read and agree to abide by Lewiston Area Farmers rules in the Code of Conduct. *

Yes

No

I agree that the Lewiston Area Farmers Market/Christian Crossings Inc/Crossings Center is not liable for any injury, theft, or damage to either the buyer or the seller, or their property, arising out of participation with the Farmers Market whether such damage occurred prior, during or after the Farmers Market. *

Yes

No

Seller indemnifies and holds the Lewiston Area Farmers Market/Christian Crossings Inc/Crossings Center harmless for and against any claims for injury, theft or damage. *

Yes

No

I understand that it is recommended that I carry my own general liability and product liability insurance because the Lewiston Area Farmers Market/Christian Crossings Inc/Crossings Center does not provide this coverage on my behalf. *

Yes

No

I agree to produce, prepare, display and store all produce in accordance with the MN Department of Agriculture, MN Department of Health and the Winona County Health Department. *

Yes

No

Date *

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DD

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