Please provide the following contact information:

Name

Vendor Name 

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Business Phone

Home Phone

FAX

E-mail

URL

Please select the day(s) you are planning to attend:

Please select activities you will be participating in: 

Daily Flying  

Night Flying

Daily Noon Flight Demonstrations.

Will you be using a Vendor Demo Pilot?:    (Yes)         (No)

If Yes, What is his Name?

I hereby give Zephyrhills Can-Am Flyers Permission to use Our Vendor name including those of our participating personnel and/or Image (Photographs) in any press release, newsletter, Official Club and Event Web Site:

Yes

No

Do you plan on donating as a Sponsor?

Yes

No

If Yes, please describe the donation in space provided or pick "To be announced" and we will add your business to the Sponsor page.

To be announced

or describe:

PLEASE, All pilots need to register in the Pilot Registration area also, thanks.