Southeast Pop-Up Show - Registration

Store Name*

Account Number*

Additional Ship-To's

Please enter all ship to numbers for your store location(s)

ASC Sales Representative*

Store Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Assumption of Risk*

By checking the box below, you acknowledge and understand the following: 1. There is inherent risk in attending an event where the vaccine status of others in attendance may be unknown to the individuals. 2. There is inherent risk for populations that may not currently be eligible for vaccination or may be immunocompromised and whose vaccine protection may be incomplete. 3. Animal Supply Company will follow all state, county and city guidelines for COVID-19 safety, including mask usage and vaccine/ testing ordinances.

I acknowledge and understand the above risks

Main Contact - Attendee 1*

First Last

Email*

Phone*

Activities - Main Contact*

Please check which activities you plan to attend

Select All
Pre-Show Reception (August 3rd)
Pop-Up Show (August 4th)

Attendee 2

First Last

Email

Activities - Attendee 2

Please check which activities you plan to attend

Select All
Pre-Show Reception (August 3rd)
Pop-Up Show (August 4th)

Attendee 3

First Last

Email

Activities - Attendee 3

Please check which activities you plan to attend

Select All
Pre-Show Reception (August 3rd)
Pop-Up Show (August 4th)

Attendee 4

First Last

Email

Activities - Attendee 4

Please check which activities you plan to attend

Select All
Pre-Show Reception (August 3rd)
Pop-Up Show (August 4th)

Notes

Anything else you need to tell us? Please do so here:

Southeast Pop-Up Show | August 3 & 4, 2022

Registration for the Southeast Pop-Up Show is Now Open!