| 1 Your Name..... |
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| 2
Company Name |
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| 3 Address........ |
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| 4 City............ |
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| 5 State..........
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| 6 Postal Zip..... |
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| 7 Telephone......
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| 8 Facsimile...... |
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| 9
Web Address. |
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| 10
Email .. |
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| 11
Resale Number if applicable |
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| Platinum
: Call (800) 880-6567 or (661) 944-2299
Included in all media advertisement |
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| Golden:
Call (800) 880-6567 or (661) 944-2299
Included in all media advertisement |
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| Silver: Call
(800) 880-6567 or (661) 944-2299
Included in all media advertisement |
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Corporate
Booth 10' W x 30' D
( w/web link) |
$ 120.00
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Vendor
Booth 10'x 20' (
w/web link) |
$ 80.00
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Vendor
Booth 10'x 10'
( w/web link) |
$ 45.00
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Website Banner (web link) |
$ 50.00
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Website Listing Only (web link) |
$ 25.00
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**New Vendors Please note: All of
our vendors from previous years get first shot. Please E-mail us for
applications and approvals first. You may be put on a waiting list.
Thank you.
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Trophy or Ribbon Sponsor Call
for Classification Availability
$ 50.00
Please Make 3 choices just
in case someone has already sponsored the class you were interested in.
Choice # 1 Choice #
2 Choice #
3
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Total Payment due $ |
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Payment Info
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Check #
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Credit
Card Visa
MC Discover
Novus
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Card # EXP Date
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All Sales Are Final, Sorry No Refunds.
I
am an authorized representative of the above company. I have read
and understand all terms and conditions stated for purchasing a
sponsorship or vendor space for "Moldy Marvin's Doin' it in the Dirt" 2009
season..
Signature
for Credit Card if applicable:_____________________________________
Date:______________________ Liability Release:
By execution of this form, I / we do hereby release and discharge
the City Of Pearblossom CA, The Outpost, Moldy Marvin, Automated Entertainment,
Kulture Shoq, The Mutilators Motor Club, any show sponsors
and any members
or employees thereof for any injuries to myself and or my
associates, all loss by theft or damage, and all damages that may occur to my
equipment, product, vehicle or vehicles while I / we
participate in Moldy Marvin Kustom Kulture Events / Season 2009.
Signature
_________________________ Date ___________
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