EmailMe Form - Local Perks Application

Business Contact Information

Participating Business Contact Name *

Participating Business Contact Title *

Participating Business Contact Phone Number *

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Participating Business Contact Email *

Participating Business Mailing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Name of the individual who referred you to the program *

Information provided in the section below reflects how the business will be listed on the Alfa Perks website

Participating Business County *

Participating Business Name *

Participating Business Benefit *

Please provide the discount and discount details available to Alabama Farmers Federation members.

Participating Business Phone Number *

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Participating Business Physical Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

A home address cannot be used as the physical address.

Participating Business Web Address or Facebook Page

If the complete URL is not provided, a link to the business will not be included on the Alfa Perks website or in the Alfa Perks app.

This Agreement constitutes the sole and entire agreement between the Alabama Farmers Federation (“ALFA”) and the Participating Business with respect to the subject matter contained herein, and supersedes and terminates all prior and contemporaneous understandings, agreements, and warranties, with respect to such subject matter. The undersigned Participating Business agrees to participate in the Alabama Farmers Federation Local Business Program and will give certain benefits to all Alabama Farmers Federation members.
Participating Business will continue to offer this benefit (or a substantially similar benefit) for one year (the “Initial Term”). This contract will automatically renew for one year after the Initial Term each year until terminated by either party. The Business may terminate this contract by giving thirty (30) days’ written notice at any time after the Initial Term. The ALFA may terminate this contract by giving thirty (30) days’ written notice at any time. This contract is effective when ALFA returns an executed copy of this Agreement to the Participating Business, until the day it is terminated.

Obligations of the Participating Business:
• Place an ALFA Membership decal at the front of the store or other prominent place so members will be able to identify that business participates in the ALFA Local Business Program.
• Offer the previously mentioned “Participating Business Benefit” to current Farmers Federation Members:

Obligations of ALFA:
• Place the business name on the ALFA website under the Local Member Benefits section.
• Provide a (ALFA Membership Discount Here) decal to be placed on the door or other prominent place.

Additional Terms and Conditions:
Members may demonstrate their current membership in the ALFA by any of the following:
• Paper or electronic Alfa Insurance proof of insurance card
• Paper or electronic ALFA Member Benefit Card

The local county Farmers Federation and ALFA (collectively the “Federation”) are not liable for financial or contractual responsibilities of members of ALFA. Further, nothing in this Agreement shall be construed to establish a joint venture, partnership, agency, franchise, or employment relationship between the Federation and the Business. The Federation shall not be liable for your products or services or for any inaccuracy in your marketing materials. You agree to indemnify, defend and hold the Federation and their affiliates and all of their employees, officers and directors harmless against any and all losses, liabilities, damages, costs or other expenses or claims or counterclaims of third persons or entities related to this Agreement, except for any such claims arising from the Federation’s gross negligence or willful misconduct. Each party waives its right to jury trial for any dispute relating to this Agreement.

Please read and check the following: *

By submitting this form, you confirm that the information contained herein is valid.

This application does not constitute a binding agreement until such time as the Participating Business receives notice of the Federation’s approval to the email provided above.

Signature *

Clear

Each party agrees that the electronic signatures of the parties included in this Agreement are intended to authenticate this writing and to have the same force and effect as manual signatures. Your submission indicates your assent to the terms contained in this Agreement. *

Please check this box to confirm you have read and understand this statement.