Please mail completed application to:  

Healthy Communities Coalition c/o Justin McIntosh 

PO Box 517  

Dayton, NV 89403 

Or email to: justin@hcclsc.org (775)-291-6270 

In order to participate in the Dayton Farmers Market, vendors must produce the goods they are selling. If you GROW IT (fruits, veggies, meat, honey or eggs), CAN IT (salsas, jams and jellies), MAKE IT (soaps, jewelry, décor and crafts, beverages, and other value-added products), or BAKE IT (breads, pastries, or cakes), we welcome you to sell it with us!  

Required for vendors: 

NV Producer Certificate and/or Cottage Food Permit (If you are selling Produce and/or Cottage Foods) 

http://agri.nv.gov/Plant/Producer_Certification/Producer_Certification_Home/ 

http://dpbh.nv.gov/Reg/Cottage/Cottage_Food_Registration_-_Home/ 

NV Sales Tax ID (required for any and all things sold, except produce) 

https://www.nevadatax.nv.gov/#

NV Health Permit (required if you sample or sell ready to eat food) 

http://dpbh.nv.gov/Reg/Environmental_Health/  

Commercial Liability Insurance ($1,000,000/$2,000,000 added liability, Healthy Communities Coalition as additional insured, required for all vendors who sell produce, food, skin products and animal products) 

All applicable licenses, certificates and permits must be submitted with the application. 

Vendors must provide their own tent, signage, and tables. We require tents to be weighted down/secured. Power is not available at the market. If you require electricity, please plan to bring your own generator.  

Business/Farm Name __________________________________________________ 

Contact Person(s) ____________________________________________________ 

Mailing Address ____________________________________________________ 

_____________________________________________ 

Email Address ____________________________________________________ 

Phone Number ______________________________ (  ) cell phone (  ) landline 

Website Address ____________________________________________________ 

Are you on (  ) Facebook   (  )Instagram Username______________________ 

Product Category (categories). Please select all that apply. 

(  ) Farm/Produce (  ) Crafter/Artisan  

(  ) Cottage Food (  ) Prepared/ Ready-to-Eat Food  

(  ) Community/ Non-Profit  

Please provide a description of the products you will be selling or the information available at your booth: 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

The market is every Thursday from 3-6 pm. We encourage our vendors to attend every week, as customers get used to purchasing from them. Please check the dates you will attend. 

(  ) June 9   (  ) June 16     (  ) June 23     (  ) June 30     (  ) July 7       (  ) July 14 

(  ) July 21    (  ) July 28    (  ) Aug. 4       (  ) Aug. 11    (  ) Aug. 18     (  ) Aug. 25 

(  ) Sept. 1      (  ) Sept. 8      (  ) Sept. 15    (  ) Sept. 22      (  ) Sept. 29 

HOLD HARMLESS/INDEMNIFICATION AGREEMENT 

Dayton Farmers Market/Healthy Communities Coalition of Lyon and Storey County 

In consideration of the Dayton Farmers Market, (DFM hereinafter) acceptance of the applicants (“Applicant”) application to participate in the DFM, (“Event”), the Applicant (its officers, directors, agents, employees, representative, and/or members) agrees to indemnify, hold harmless, protect, and defend the DFM as well as its agents, employees, and/or representatives, from and against any and all loss, claim of loss, injury (including, but not limited to, personal injury), damages (including, but not limited to, property damage), liability, or other expense or claim by a third party or Applicant (or any officer, director, agent, employee, presentative, and/or member of the Applicant), that arises out of, or is in any manner, related to any act or failure to act by the Applicant (its officers, directors, agents, employees, representatives, and/or members) in connection with the Applicant’s participation in this Event.  

I hereby affirm that I have read and understand the Hold Harmless/ Indemnification Agreement and agree to the terms expressed therein.  

The undersigned has read this Agreement carefully and represents that he or she has the authority to execute this Agreement on behalf on of the Applicant.  

Signature: ________________________________________________________ 

Print Applicant Name:  _________________________    Date:______ 

VENDOR AGREEMENT 

All Participants must adhere to the Rules and Regulations. By signing below, I certify that I have read, understand and agree to adhere to all applicable Rules and Regulations. I further understand that should I fail to comply with the Rules and Regulations, my participation in the Dayton Farmers Market may be terminated.  

Signature: ________________________________________________________ 

Print Applicant Name:________________________   Date:_______________ 

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