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Community Day Vendor Application

  1. 2022 UPT Community Day
  2. Community Day Vendor Application

    Please complete the form below to apply as a vendor for the Upper Providence Township 2022 Community Day Celebration.

    • Date: Saturday, September 17, 2022 (RAIN or SHINE)
    • 5k Race and 1 Mile Family Fun Run/Walk Start Time:  9:00 a.m.
    • Activities and Games Start Time:  11:00 a.m. – 3:00 p.m.
    • Location Rose Tree Park, 1671 N. Providence Road, Media
    • Vendor Forms are Due By: August 26, 2022

    You may upload the following REQUIRED forms below:

    • SIGNED Vendor Terms & Conditions
    • Insurance / Waiver of Liability naming Upper Providence Township and Rose Tree Park as additionally insured
    • Food Vendors - Department of health Certificate


  3. (if different from physical address)

  4. Your Business Category*

    Please check the appropriate category and charges. ALL applications MUST include a certificate of insurance/waiver of liability naming Upper Providence Township and Rose Tree Park as additionally insured.

  5. Please provide a description of the services your organization provides

  6. Please provide a description of the food that will be offered

  7. Payment Instructions

    Make checks Payable to “Upper Providence Township”.  Applications will not be considered complete without payment and a certificate of insurance/waiver of liability.


    Applications and payment can be sent via U.S. Mail or submitted in person. The Township Business hours are Mon-Fri 8:30 am to 4:30 pm., except for Holidays.

  8. Signature*
  9. Upload Required Forms
    • SIGNED Vendor Terms & Conditions
    • Insurance / Waiver of Liability naming Upper Providence Township and Rose Tree Park as additionally insured
    • Food Vendors - Department of health Certificate
  10. Sign & Return Vendor Terms & Conditions Form
    • You must sign and return the Vendor Terms and Conditions Form HERE.
    • Applications without a signed Vendor Terms and Conditions Form will not be accepted.
  11. Insurance / Waiver of Liability must name Upper Providence Township and Rose Tree Park as additionally insured


  12. Food Vendors Only

  13. Leave This Blank:

  14. This field is not part of the form submission.