Sponsor Registration Form

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PRODUCTS OR SERVICES *

CONTACT PERSON *

VIP VENDOR PACKAGES *

Bronze Sponsor Package #1 - $600 (3 Events)

Silver Sponsor Package #2 - $1,200 (6 Events)

Gold Sponsor Package #3 - $1,800 ( 9 Events)

Platinum Sponsor Package #4 - $2,400 (12 Events)

Diamond Sponsor Package #5 - $3,000 (15 Events)

Black Diamond Sponsor Package #6 - $5,000 (Unlimited Events)

CREDIT CARD 3-DIGIT CODE (ON BACK OF CREDIT CARD) *

NAME ON CREDIT CARD *

CREDIT CARD EXPIRATION DATE *

CELL PHONE *

Ladies Pamper Night reserves the right to use any photograph/video taken at any event sponsored by Ladies Pamper Night, without the expressed written permission of those included within the photograph/video. Ladies Pamper Night may use the photograph/video in publications or other media material produced, used or contracted by Ladies Pamper Night including but not limited to: brochures, invitations, books, newspapers, magazines, television, websites, etc. *

I agree

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SPONSOR REGISTRATION FORM

TERMS AND CONDITIONS: I HAVE READ AND AGREE WITH THE TERMS AND CONDITIONS - I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree with the Terms and Conditions *

I agree with the terms and conditions

I do not agree with the terms and conditions

STATE *

CREDIT CARD BILLING ADDRESS *

Email: *

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NAME OF COMPANY *

HOW DID YOU FIND US? *

CITY *

NAME OF BANK *

ZIPCODE *

CREDIT CARD NUMBER *

We received your registration form! You will receive an invoice within the next two hours. Once payment is submitted we will secure your space. We look forward to meeting you and hosting a fabulous event. Thank You for your business!

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