Area: This Entitles Each Pro Shop/Vendor to a Maximum Area of 18M2 Only

STATE CHAMPIONSHIPS PRO SHOP/VENDOR APPLICATION

Applicant Company Name Postal Address Suburb Postcode Contact Name Contact No Wk Mob Email Address Products Sold Public Liability Insurance Company Name Insurance Policy Number Insurance Expiry Date Copy of Current Insurance Policy attached

Event: State Championships, Southside BMX club, Thursday 5th October to Saturday 7th October 2017

Cost: $300 + GST

Area: This entitles each Pro shop/Vendor to a Maximum area of 18m2 only. (Tent NOT Supplied)

Allocation: Site allocation is completed by BMX Sports Western Australia, by way of random draw. (Exception being the Host Clubs regular Pro Shop Supporter, who may be given First preference)

Bookings: Can ONLY be made through the BMX Sports Western Australia Office, along with your Application form and Payment.

Payment: Must be received by Thursday 14 September 2017 **Please Note: A Tax invoice/Receipt as required will be issued after payment has been received. Payment can be made by Cheque, Credit Card, or Direct Deposit

Bank Account Details: Account Name: BMX Sports Western Australia BSB: 036 237 Account Number: 170053

If paying by Direct Deposit please send remittance email to: [email protected] stating invoice number, payment amount and date. Cheque Cheque Number Credit Card Visa MasterCard Bankcard Card Expiry Security / / / / Number Date Code Cardholder’s Name Cardholder’s

(print) signature Page 1 of 2 Pro Shop – Vendor Agreement 2017 State Championships

I/We ______(Print name)

______(Sign name)

Hereby agree to abide by the following:

1. BMX Sports Western Australia has full control on placement of Pro Shop and Vendors at the 2017 State Championships.

2. Pro Shops – Vendors may not be a company producing or selling tobacco, alcohol, pre or post workout supplement products or pornographic products and must not be involved in sports betting.

3. Setup of Pro Shop – Vendor can be conducted on Thursday 5th October until Saturday 7th October 2017.

4. Pro shop is to attach a copy of their CURRENT Public Liability Insurance policy.

BMX Sports Western Australia Inc 105 Cambridge Street West Leederville WA 6007 | PO Box 1387 West Leederville WA 6901 P: 08 6336 9685 | E: [email protected] | W: www.bmxsportswa.com.au ABN: 38 189 688 320