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2. 
3. Touch A Truck Application
5. Applicant Name*
6. Business/Contact Name
8. Street Address*
10. City*
11. State*
12. Zip Code*
14. Email Address*
15. Phone Number*
17. Please describe vehicle / equipment that will be on display*
19. Registration Requirements*

    Check each box to indicate you have read and understand each registration requirement

    1. Commercial Vehicles – I agree to present a copy of commercial insurance prior to event date.
    2. Personal Vehicles – I agree to present a copy of liability insurance prior to event date.
    3. I agree to have all displays in place no later than 10:00am to be ready for event start time of 11:00am.
    4. I agree to have an attendant present at the vehicle / equipment at all times during the event.
21. Liability Release

    I / We assume all risks and hazards related to the La Vergne Touch A Truck event.   I / We do further indemnify, hold harmless, and forever release the City of La Vergne, producers, sponsors, support personnel or anyone else connected with the presentation of this event from any and all claims, actions, and judgments due to losses, injuries, death, or damages incurred at the event.  In consideration of this entry, entrant agrees to the use of their name, photo and/or vehicle/equipment photo for publicity and/or advertising. 

23. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
25. Electronic Signature*

27. Please direct all questions to Kathi Melendy at 615-793-3224 or kmelendy@lavergnetn.gov. 

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field