Screenings for Blood Pressure, Blood Glucose, & Lung Function, Learn Sidewalk CPR and meet our experts on Diabetes, Stroke and Heart Failure

Transcription

1 2nd Annual Presented by the Auxiliary of Pomona Valley Hospital Medical Center Saturday October 20, :00am-2:00pm 1830 N. Orange Grove Ave., Pomona Across from Pomona Valley Hospital Medical Center Open to ALL Pre-1976 CLASSIC car enthusiasts: Exotic, Hot Rod, Street Rod, Race Car, Vintage Car, Truck & Motorcycle owners who want to show off their ride. The Charity Car Show is a celebration Pre-Registration: $30 per vehicle Pre-Registration includes event t-shirt & first 100 receive a free lunch Day of Show: $40 per vehicle Day-of Registration includes t-shirt only Staging from 7am to 9am FOOD RAFFLE PRIZES MUSIC BY DJ GARY FREE HEALTH FAIR Screenings for Blood Pressure, Blood Glucose, & Lung Function, Learn Sidewalk CPR and meet our experts on Diabetes, Stroke and Heart Failure VENDOR FAIR FREE TO ATTEND TODD Memorial Some Babies Need A Helping Hand For 80 years, the Auxiliary of Pomona Valley Hospital Medical Center has worked to provide funds for the patients and programs at PVHMC. Purchasing car seats for our tiniest patients, providing transportation for parents, paying bills for families, and purchasing equipment for departments throughout the Hospital are just a few of the things we help with. Your support of this event will help the Auxiliary continue its support of our Hospital and the communities it serves. For questions, information, or to become a sponsor: Call or us at volunteer@pvhmc.org Have a Classic Car or Truck? Register Today! Registration Form on Back!

2 Hosted by the Auxiliary of Pomona Valley Hospital Medical Center VENDOR APPLICATION The Auxiliary of Pomona Valley Hospital Medical Center thanks you for participating in the 2 nd annual Charity Car Show. We look forward to working with you and thank you for your help in our fund raising efforts for the Sick Baby and Hospital Assistance Fund. Cost for Space: $35 GUIDELINES As a participant in this year s Car Show, we respectfully ask that you follow our guidelines when submitting your application. HOURS / SCHEDULES Saturday, October 20, 2018 Event hours: 9:00 a.m. to 2:00 p.m. Vendor set-up: 7:00 a.m. to 8:30 a.m. Vendor break-down: 2:00 p.m. to 3:00 p.m. ACCEPTANCE / PLACEMENT Placement at the event will be assigned by the Auxiliary. The Auxiliary of Pomona Valley Hospital Medical Center reserves the right to limit the number of applicants for any one goods/ services category. BOOTH SPACE Standard vendor booth space is approximately 12 wide by 15 deep. Only your vendor booth space is provided; tables, chairs, etc. are the responsibility of the vendor. You will be responsible for providing the labor needed for all your items related to the setup and breakdown of your vendor booth space (tables, chairs and materials, E-Z Up's etc.). Canopy and awnings must fit within your vendor booth space. Your booth should be displayed as tastefully as possible; this is a family friendly event. No stolen merchandise, fire-arms, ammunition, explosives, alcoholic beverages, drugs or illegal items are permitted on the grounds. SELLER S PERMIT / TAXES A valid copy of your California State Board of Equalization Seller s Permit is required if you will selling items. If you do not have a Seller s Permit, to obtain a permit call (626) Vendors are responsible for collecting and reporting sales tax. LIABILITY INSURANCE You are responsible for your own liability and worker s compensation liability insurance. Please have a copy of your Liability Insurance with you. GENERATOR Electrical outlets are not provided. Vendors will need to bring their own generator for your electrical needs. Page 1 of 3

3 FIRE EXTINGUISHER You must provide a certified fire extinguisher required by the Fire Marshal (2A 10 BC). Must be visible in your booth. REFUNDS No refunds will be issued in case of inclement weather, acts of nature or restrictions by governmental agencies to cancel the event, over which the Auxiliary of Pomona Valley Hospital Medical Center has no control. SUBMISSION REQUIREMENTS Completed Application with Signature Checks may be made payable to Auxiliary of Pomona Valley Hospital Medical Center or MasterCard/Visa is also accepted Please provide copies of the following with your application: Questions, call the Volunteer Office at (909) : Valid copy of your State Board of Equalization Seller s Permit (if you are selling items) Valid copy of your liability insurance Page 2 of 3

4 VENDOR APPLICATION BUSINESS NAME: FIRST NAME: LAST NAME: STREET ADDRESS: CITY/STATE/ZIP: PRIMARY PHONE: WEB SITE: STATE BOARD OF EQUALIZATION SELLERS PERMIT NUMBER (IF APPLICABLE): TYPE OF BOOTH: Not-for-Proft Health/Medical Business/Retail Booth Business/Information Booth DESCRIPTION OF BOOTH (Physical Description and What is the purpose of your booth informative/selling/etc.: Bring or COMPLETED Application to: Volunteer Department Pomona Valley Hospital Medical Center 1798 N. Garey Ave. Pomona, CA volunteer@pvhmc.org I agree to indemnify and hold the Auxiliary of Pomona Valley Hospital Medical Center and Pomona Valley Hospital Medical Center, their officials, staff and agents harmless of and from any and all actions, causes of action of every kind in law or equity, suits, debts, liens, contracts, agreements, promises, claims, liabilities, demands, obligations, loss, costs and expense of any nature whatsoever, known or unknown, fixed or contingent, including, without limitation, attorney s fees and court costs through and including any appeals, taxable or otherwise, incurred, either directly or indirectly, as a result of my participation in the Auxiliary s Charity Classic Car Show, including but not limited to, any claims which might be made by myself, my co-workers, my agents, my employees, and/or any member of the general public. I understand and agree that The Auxiliary of Pomona Valley Hospital Medical Center and Pomona Valley Hospital Medical Center is in no way responsible for my property/or its safety. I understand and agree that there are no refunds or rain checks due to inclement weather or space assignment. I further understand and agree that I may be removed from the event if I am selling merchandise that differs from the application description submitted. I grant permission for Pomona Valley Hospital Medical Center to use photos of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content unless otherwise noted. SIGNATURE DATE OFFICE USE ONLY - Date Received Amount Paid $ Check # Page 3 of 3

5 Sponsor Information Name Charity Classic Car Show Saturday, October 20, 2018 Hosted by the Auxiliary of Pomona Valley Hospital Medical Center Business Address Phone The Auxiliary s annual philanthropic events support the Sick Baby and Hospital Assistance Fund of Pomona Valley Hospital Medical Center F r i e n d s o f t h e A u x i l i a r y The Auxiliary is proud to provide the funding for these and many other worthwhile programs and projects. Your generous sponsorship will help to ensure we can continue to fund projects like these, and many more. $5,000 - $10,000 Cadillac Sponsor A generous donation of this amount could help purchase a new electric shuttle car, providing free transportation for patients and families to the Robert and Beverly Lewis Family Cancer Care Center and around the PVHMC campus. You select the Best in Show Trophy winner engraved with your business name. Includes a trophy for your company to keep, an event booth, your logo to be included in all marketing, advertisements, event flyers and event T-Shirt $1,000 Shelby GT Sponsor The average scholarship awarded to local high school and college volunteers pursuing a career in medicine. A trophy will be named for your business, an event booth, your logo on our advertisements, flyers and T-Shirt $250 Charger Level Six families in need will receive a free new car seat to take their newborn baby home in safe and sound. Logo included on all advertisements and T-Shirt Donate a Raffle Prize valued at a minimum of $50 R a f f l e P r i z e D o n a t i o n $2,500 - $5,000 Corvette Sponsor A generous donation of this amount could cover the annual cost for our Care-A-Van program, providing free transportation for families from the High Desert to visit their critically ill baby. You select the Sponsors Choice Trophy winner, engraved with your business name. Includes a trophy for your company to keep, an event booth, your logo to be included in all marketing, advertisements, event flyers and on event T-Shirt $500 GTO Level Our annual pledge to provide new clean clothing to our homeless patients when they are discharged from the Hospital. Includes an event booth, your logo on our event advertisements, flyers and T-Shirt $100 Chevelle Level The Hospital s Palliative Care Team will be able to give seven children a copy of a very special book to help them deal with the loss of an immediate family member. Logo included on all advertisements Donate a Gift Certificate of $10 or more towards a prize All raffle donors will be recognized on the raffle item(s) donated and announced at the event Please return this completed form with your donation in the enclosed envelope by mail or in person to the Volunteer Office. For logo to be included on event T-shirt, donations must be received no later than September 30, 2018 If you have any questions or wish to have more information, please call us at All Donors will receive a receipt for their contribution. The Auxiliary of Pomona Valley Hospital Medical Center is a not-for-profit 501(C)(3) corporation and all donations are tax deductible up to the full extent allowed by law.

6 Presented by the Auxiliary of Pomona Valley Hospital Medical Center SPONSORSHIP OPPORTUNITIES Would you like to be a sponsor to support the Sick Baby and Hospital Assistance Fund? Contact us at or at volunteer@pvhmc.org $5,000 - $10,000 Cadillac Sponsor A generous donation of this amount could help purchase a new electric shuttle car, providing free transportation for patients and families to The Robert and Beverly Lewis Family Cancer Care Center and around the PVHMC Campus. You select the Best in Show Trophy winner engraved with your business name. Includes a trophy for your company to keep, an event booth, your logo to be included in all marketing, advertisements, event flyers and event T-Shirt $1,000 Shelby GT Sponsor The average scholarship awarded to local high school and college volunteers pursuing a career in medicine. A trophy named for your business will be awarded, includes an event booth, your logo on our advertisements, flyers and T-Shirt $250 Charger Level Six families in need will receive a free new car seat to take their newborn baby home in safe and sound. Logo included on all advertisements and T-Shirt $2,500 - $5,000 Corvette Sponsor A generous donation of this amount could cover the annual cost for our Care-A-Van program, providing free transportation for families from the High Desert to visit their critically ill baby. You select the Sponsors Choice Trophy winner, engraved with your business name. Includes a trophy for your company to keep, an event booth, your logo to be included in all marketing, advertisements, event flyers and on event T-Shirt $500 GTO Level Our annual pledge to provide new clean clothing to our homeless patients when they are discharged from the Hospital. Includes an event booth, your logo on our event advertisements, flyers and T-Shirt $100 Chevelle Level The Hospital s Palliative Care Team will be able to give seven children a copy of a very special book to help them deal with the loss of an immediate family member. Logo included on all advertisements For questions, information, or to become a sponsor: or volunteer@pvhmc.org Your registration confirmation, event information, and Parking Pass will be mailed to you on or before October 10. Owner s Name: Address: Phone: Mail this form with check, payable to: PVHMC AUXILIARY 1798 N. Garey Ave. Pomona, CA Car Info Year: Make: Model: Color: Car Club Info: Club Parking Requested: YES NO Clubs/Groups with 6+ registrations may request reserved parking if available. All group completed registrations must be submitted together with payment no later than October 5, T-Shirt Size: Small Medium Large X-Large XX-Large 3X-Large Please Circle (Each Registration includes one Event T-Shirt) PRE-REGISTRATION - $30 - Must be received by October 5, 2018 First 100 Pre-Registrations include one free Lunch from Tony s Famous French Dips REGISTRATION AT EVENT: $40 (day of registration does not include lunch) Cash, Check, and Credit Card accepted in person at the Volunteer Office. The Auxiliary of Pomona Valley Hospital Medical Center reserves the right, to reject any registration as well as prohibit the participation of any entrant due to vehicle condition, or entrant s or entrant s guest s objectionable behavior or conduct. Vehicle s artwork must be appropriate for a family oriented event. No tailgating and No Alcohol allowed. NO REFUND POLICY The PVHMC Auxiliary Charity Car Show has a No Refund Policy and is not responsible for Acts of God and will present the event on a rain or shine basis or move the event date at their discretion without refund to the registered participant. Registrations are non-refundable. RELEASE OF CLAIMS In consideration of the acceptance of the right to participate in the Auxiliary of Pomona Valley Hospital Charity Classic Car Show 2017, by execution of this form, I agree to indemnify and hold harmless Pomona Valley Hospital Medical Center, it s Auxiliary, the City of Pomona, all agents, sponsors, vendors, employees and volunteers, from and against any and all known and unknown damages, injuries and or losses that the participants and or the participants guests (including family and relatives) may sustain or incur as a result of their attendance or participation at this event. ENTRANT SIGNATURE: