IPM 2018 Registration Form for Antique and Historical Exhibitors September 18 - 22, 2018 Pain Court, Chatham, Ontario
This form must be filled out prior to Sept. 1, 2018. If this date has passed, please contact Jerome Roy at jaroy59@hotmail.com 519-401-4123 or Roger Bourassa at roger.r.bourassa@cogeco.ca 519-436-7059.
Email address *
Please review the Antiques & Historical Exhibitor's Safety Rules, Regulations and Information.
I certify that I have read and understood the 2018 International Plowing Match & Rural Expo "Antique and Historical Exhibitor's Safety Rules, Regulations and Information" and agree to comply with these agreements. *
Required
Name *
Your answer
Email Address *
Your answer
Mailing Address *
Your answer
Telephone Number *
Your answer
Description of Display, Information for the Display Card. *
Your answer
The Display is: *
The space required for your display (Square Foot) Other requirements? *
Your answer
*I understand that I must provide a valid insurance certificate that states I/we carry a minimum of $2 million comprehensive liability insurance and lists the Ontario Plowmen's Association and the International Plowing Match & Rural Expo as an additional insured.* *
Steam Certification # (if required)
Your answer
Electronic Signature and Date: *
Your answer
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