Sign Up Business Name Type of Business Vendor Requesting a kiosk in retail location Business EIN / Tax Information Email Address Line 1 Address Line 2 City / State / Country Zip Code Contact Number Contact Name Number of active gym members/volume of people visiting your location daily? Do you currently sell retail items? If so, how many SKUs? Where did you hear about us? Social Media Google Search Friend Other Comment I agree with the terms & conditions Name and Signature Agree Date
