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New Dealer Form

  • Regal Lager Authorized Dealer Agreement

  • For multiple stores and/or warehouse locations please attach at the end of this form.

  • Credit Card Authorization:

    By clicking Submit on this form, I authorize REGAL LAGER, INC. to charge my Credit Card account for the full purchase amount on the full amount due for products and related charges purchased from them. Nothing herein shall be construed as a waiver of any rights or remedies REGAL LAGER, INC. may have with respect to collecting any amounts due on account of Retailer.

  • I have read and understand the Regal Lager, Inc. Authorized Dealer Agreement and by my authorized signature below agree to be bound by its terms.

  • Should be Empty: