3RD ANNUAL WORMBURNER EVENT:

3rd Annual Wormburner Sponsorship

Please enable JavaScript in your browser to complete this form.

Total Amount

$0.00

Organization / Business

Contact Name

First

Last

Email Address

Phone Number

Company Logo

Click or drag a file to this area to upload.

Please provide a high resolution company logo for use in marketing material.

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Credit Card Information

Card Number

Expiration

Security Code

Information Company Contact

Confirmation

Confirmation (copy)

I acknowledge that upon submitting this form, my orders are final and can no longer be canceled

JUST OFF INTERSTATE 5 - EXIT 773
777 Casino Way
Yreka, CA 96097

Phone: 1-530-777-RAIN

OPEN DAILY

7:00 AM - 3:00 AM

OPEN DAILY

7:00 AM - 9:00 PM

SUNDAY - THURSDAY
12:00 PM - 10:00 PM

FRIDAY
12:00 PM - 12:00 AM

SATURDAY
5:00 PM to 12:00 AM

*Closed Daily from 3:00 PM to 5:00 PM