Vendor / Business Name*

Contact Name*

Email Address*

Phone Number*

Company Type / Category (Check all that apply)*

Healthcare / Clinical Services

Fitness / Movement

Nutrition / Food & Beverage

Mental Health / Mindfulness

Holistic / Alternative Wellness

Sleep / Recovery Products

Wellness Retail / Health Products

Community Organization / Non-Profit

Other

If other, please specify:

Will you be offering any samples at your booth?*

Yes

No

If yes, please describe:

Will you be selling any products or services onsite?*

Yes

No

If yes, please describe briefly (e.g., product type, price range):

Are you able to donate a prize for our event giveaway?*

Yes

No

If yes, please describe the prize:

Will you require access to the following (check all that apply)

Power outlet

Wi-Fi

Additional chairs

Other

If other, please specify:

Do you have any special setup requests or accessibility needs?*

Yes

No

If yes, please explain:

Please upload your company logo (for internal promotion)*

Submit

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