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Name Price Qty Total

Name	Price	Qty	Total
Double Head Silver Location 1 Location Remove	$39.99	Update	$39.99
Sub Total:			$39.99

Double Head Silver Location

1 Location

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$39.99

Update

$39.99

Sub Total: $39.99

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Restaurant or Bar Location Only Upgrade $10.00

Regular Price $10.00

$10 extra per location to guarantee Restaurant and Bar Locations Only.

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Billing Information
* First Name
* Last Name
Company Name
* Address - Line 1
Address - Line 2
* City
State
* Zip Code
* Country
* Phone Number
* Email Address

Payment Information
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Credit Card Type	Credit Card Number	Expiration Date

After You Checkout you will receive an email request for the following additional information:

Zip Codes where you want your machines located.
Commission % We suggest a 20% commission to businesses, 15% minimum is required.
Appointment Schedule when you’re available to drop machines off.
Products You Offer in your machines. Candy, Gumballs, etc.
Business Categories you prefer to have your machines located in.

By proceeding I acknowledge I have read and agree to Kick Start Locations terms of service.

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Refunds

Platinum Locations - In the event we're unable to secure your initial platinum locations (not replacements) you'll receive a full refund for each locatin we were unable to secure.

Free Replacement Locations - In the event we're unable to secure replacement locations you'll receive a $20 refund per location we were unable to secure.

$20 Discounted Replacement Locations - In the event we're unable to secure replacement locations you'll receive a $20 refund per location we were unable to secure. One discounted replacement may be ordered per platinum location.