Referral Agent Agreement

1 Your Identity

We are required to verify your identity before processing any commission payments.

Full Legal Name *

Email Address *

WhatsApp Number *

Phone Number (if different)

Residential Address *

2 Identity Verification

Please upload a clear photo or scan of a valid government-issued ID. This is required for KYC compliance and to process commission payments.

ID Document Type *

Document Reference Number * Stored securely and used for identity verification only

Upload ID Document *

📄

Tap to upload or drag & drop

Accepted: JPG, PNG, PDF · Max 10MB

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3 Payment Details

Commission will be paid monthly to the bank account below. All fields are encrypted and stored securely.

Bank Name *

Account Holder Name *

Routing Number (ABA) *

Account Number *

4 Commitment Fee

⚡ Select your country above to see the commitment fee

The commitment fee is payable after this form is submitted and your venue is jointly confirmed. No fee is charged until your venue has been reviewed and approved — you will never pay only to be rejected.

I understand that a commitment fee is payable after venue confirmation, and that this fee is non-refundable once the machine has been dispatched. *

5 Signature

Please sign below using your mouse, trackpad, or finger on a touch screen.

Print Full Name *

Date * Format: DD/MM/YYYY

Signature *

I have read and agree to all terms of the Referral Agent Agreement, including the revenue share structure, maintenance obligations, and commission forfeiture clauses. *

1 Your Identity

2 Identity Verification

3 Payment Details

4 Commitment Fee

5 Signature

Agreement Preview

Agreement Signed!