Payment Account Setup – Sponsor the Coastal Carolina Fair

Sponsorship Level *

Full Legal Name - Prefix First Middle Last Suffix *

First

Middle

Last

Sponsor / Company Name *

Phone *

Email *

Type of Payment Account *

Mailing Address for the Card - Must Match

Address Line 1

Address Line 2

City

State

Zip Code

Picture of the FRONT of your Check *

Click or drag a file to this area to upload.

Images are used for security purposes and accuracy confirmation.

Picture of the FRONT of your Debit or Credit Card showing your name as it matches your account *

Click or drag a file to this area to upload.

Images are used for security purposes and accuracy confirmation.

Picture of the BACK of your Debit or Credit Card *

Click or drag a file to this area to upload.

Images are used for security purposes and accuracy confirmation.

Checkboxes *

By clicking the Submit Button, I authorize the Coastal Carolina Fair to charge my checking account or credit card, specified above or used at any time in the future, for the payment of any or all of my charges and/or for charges incurred this year or future years sponsorship. I also understand that I may terminate this agreement by giving seven (7) days written notice to the Coastal Carolina Fair, allowing a reasonable amount of time after receipt for the Coastal Carolina Fair to act upon it.

Signature *