2018 SUPER CRUISE VENDOR PAYMENT 2018 SUPER CRUISE EVENT VENDOR PAYMENT FORM Sat., Mar. 3, 2018 Rain or Shine Car/Motorcycle Show (Online payment will continue thru February 17, 2018)Unique IDVENDORFirst Name*Last Name*Company or Business*Product/Services Offered*Address* Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email-will be used to send your verification back to you* Phone*Vendor Space-Supporter ($50 each space) Price: $50.00 Quantity: (1) 10 x 10 space for day of the event, located on site layout. No power available. Announcer will recognize you during the Super Cruise event. Deadline February 16, 2018, locations will be designated upon payment in full.TOTAL $0.00 PAYMENTSelect Payment Method*Select belowPayPalCredit CardWhen you click the Submit button you will be directed to PayPal to complete your purchase!Credit Card*> This is a secure SSL encrypted payment. American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name CAPTCHARemarks:*Liability Release: In consideration of the acceptance to participate. Entrants, participants, spectators and/or riders release and discharge BCCC, Inc. its officers, agents, representatives, directors, volunteers, servants, sponsors, affiliates clubs, sponsors, vendors, Fred Hall/Cal Shows, Kern Co. Fairgrounds and all owners and management of Kern Co. Fairgrounds and any and all clubs and organizations affiliated with BCCC or Kern Co. Fairgrounds from any and all known or unknown causes whatsoever that may be suffered by anyone participating in this event to his/her person or property. Event Management reserves the right to restrict entrants and/or their guests to behavior deemed acceptable during all activities of this event, including eviction should it become the opinion of event management that it is in the interest of safety, and/or proper behavior. The undersigned entrants acknowledge by his/her submission as having read and understood the above release of liability and waives all claims as outlined within. Liability release to include all passengers. Rain or Shine Event.