Vendor Application (All Events)

Name*

First NameLast Name

Zip Code*

Email*

example@example.com

Vehicle Year/Make/Model*

Photo Release Form*

For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby grant the Juneteenth GVL Organization permission to use my likeness in a photograph in any and all of its publications, including but not limited to all of Juneteenth GVL printed and digital publications. I understand and agree that any photograph using my likeness will become the property of the Juneteenth GVL Organization and will not be returned. I acknowledge that since my participation with Juneteenth GVL Organization is voluntary, I will receive no financial compensation. I hereby irrevocably authorize Juneteenth GVL Organization to edit, alter, copy, exhibit, publish or distribute this photo for publicizing Juneteenth GVL programs or any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including a written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge Juneteenth GVL Organization from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

Consent To Photo Release*

Yes

Signature*

How did you hear about this event?*

My Products:

Car & Bike Show Registration

$25.00 Quantity

Freedom Ride T-Shirt$20 - $24 (Sizes @X & Up, $24)

$20.00

Size	Quantity	Price
XS		$20.00
S		$20.00
M		$20.00
L		$20.00
XL		$20.00
2X		$24.00
3X		$24.00
4X		$24.00

Juneteenth GVL T-Shirt

$20.00

Size	Quantity	Price
XS		$20.00
S		$20.00
M		$20.00
L		$20.00
XL		$20.00
2X		$24.00
3X		$24.00
4X		$24.00

Wellness T-Shirt

$20.00

Size	Quantity	Price
XS		$20.00
S		$20.00
M		$20.00
L		$20.00
XL		$20.00
2X		$24.00
3X		$24.00
4X		$24.00

BeverageWater & Pepsi Products

$3.00

	Quantity
Water
Pepsi
Diet Pepsi
Pepsi Zero
Mountain Dew

Bundle - Premium(2)T-Shirts, Sanitizer, Notepad, & Stainless Steel Tumbler

$55.00

Bundle T-Shirt, Sanitizer, Notepad, & Water Bottle

$35.00

Notepad

$7.00

Tumbler16 oz Stainless Steel Tumbler

$10.00

Sanitizer

$3.00

Water Bottle20 oz Plastic

$7.00

	Quantity
Red
Black
Green

Donation

$5.00

	Quantity	Price
5		$5.00
10		$10.00
20		$20.00
50		$50.00
100		$100.00

Item subtotal:$0.00

Enter coupon

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Cash App Pay

If you would like more information please contact:

Dionne Washington, Logistics Director

logistics@juneteenthgvl.org | 864.205.7725

Freedom Ride Registration

Payment Methods