DOWNTOWN WAVERLY, 200 BLOCK OF 1ST AVE SE

APPLICATION FOR PERMISSION TO SELL

Date:_________________________________________________________________________

Name:________________________________________________________________________

Business Name:________________________________________________________________

Address:______________________________________________________________________

Phone number:________________________________________________________________

Email address:_________________________________________________________________

Items for sale (please specify):

Vegetables/Herbs_________________________________________________________
________________________________________________________________________

Fruits__________________________________________________________________
________________________________________________________________________

Baked Goods ____________________________________________________________
________________________________________________________________________

Crafts__________________________________________________________________
________________________________________________________________________

Flowers/Plants___________________________________________________________
________________________________________________________________________

Other__________________________________________________________________
________________________________________________________________________

AFFIDAVIT

I ________________ hereby agree to sell or offer for sale at the Waverly Farmer’s Market only such items as listed above, as my own production on the above described property. I have read and am fully aware of the rules of the Waverly Farmer’s Market. I further acknowledge full responsibility for all items.

Signature _____________________________________________________________________