Brewery Information Form

"*" indicates required fields

Brewery Name*

Primary Contact

Email*

Name*

First Last

Job Title*

Phone*

Secondary Contact

Name

First Last

Job Title

Phone

Please Tell Us What Lager(s) You Plan To Serve

Lager #1 Beer Name:*

Lager #1 Format*

Lager #1 Price:*

Lager #1 Beer Style / Description:*

As you would like it to read in the event program guide.

Lager #2 Beer Name:*

Lager #2 Format*

Lager #2 Price:*

Lager #2 Beer Style / Description:*

As you would like it to read in the event program guide.

Lager #3 Beer Name:

Lager #3 Format

Lager #3 Price:

Lager #3 Beer Style / Description:

As you would like it to read in the event program guide.

Lager #4 Beer Name:

Lager #4 Format

Lager #4 Price:

Lager #4 Beer Style / Description:

As you would like it to read in the event program guide.

Staff, Volunteers, Ice, & COI

Staff Member #1 Name*

First Last

Staff Member #2 Name

First Last

Staff Member #3 Name

First Last

Staff Member #4 Name

First Last

Would you like volunteers to help you pour?*

YES, for the full session

YES, ONLY for 2nd Half

NO, not for any part of the session

# of Pounds of Ice you need for your tent:

Please Upload your CERTIFICATE OF INSURANCE (if available now):

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, xls, xlsx, rtf, Max. file size: 50 MB, Max. files: 4.

Upload if you have available now (or email to [email protected] once you do.) 2 Entities should be listed as "Additional Insured": Black Flannel Brewing Co., 56 Main Street, Essex Junction, VT 05452 - AND - Eurowest Properties, Inc. (DBA. Essex Experience), 21 Essex Way, Suite 107, Essex, VT 05452

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