Dairy Queen Gift Card Enrollment Packet US

COVER SHEET GIFT CARD ENROLLMENT

Please include this cover sheet with your enrollment paperwork.

| 1. | Select one then fill in date: | |-------|------------------------------------------------------------------------| | | ☐ I am enrolling a NEW location (has never accepted Gift Cards before) If so, anticipated date of opening is ☐ I am enrolling an existing location. If so, what was the date of sale/change in ownership? | | 2. | What is the Dairy Queen Store Number? Store No | | 3. | Where should we send your initial inventory of DQ/OJ Gift Cards? ☐ Use store location address ☐ Other Address Business Name: Street Address: City/St/Zip: Attn: Phone: | | Daire | One on Cit Card Farallment Backet IIS | Dairy Queen Gift Card Enrollment Packet US

SECTION A: PARTICIPATION AGREEMENT

INSTRUCTIONS:

Step 1. Print 2 copies of the attached Participation Agreement.

Participation Agreement - Page 1

• Step 2. On the first line, enter today's date.
• Step 3. On the third line, enter the legal entity name of the Operated Location, Participating Franchisee or Sub-Franchisee.

Participation Agreement - Page 10

• Step 4. On the first line, enter the legal entity name of the Operated Location, Participating Franchisee or Sub-Franchisee.
• Step 5. On the remaining lines, sign and enter your name, title, street address, city, state and zip code of the legal entity name, telephone number, fax, email and today's date.

Participation Agreement, Exhibit A

• Step 6. In Section 4 of Exhibit A, enter the bank name, account number, account title (example: legal entity name of Operated Location, Participating Franchisee or Sub-Franchisee) that account is under and account ABA routing number. Attach a voided check for the account.
• On the second page of Exhibit A, enter the legal entity name of the Operated Location, Participating Franchisee or Sub-Franchisee on the first line. On the remaining lines, sign and enter your name, title, street address, city, state and zip code of the legal entity name, telephone number, fax and email. Also, please enter your Tax ID number.

Participation Agreement, Exhibit B

Step 8. List each Dairy Queen or Orange Julius Store Number and address information for each Designated Location that you are signing up for the Program.

Participation Agreement, Addendum #1 (Addendum for FD-150 Terminals)

NOTE: Only use/complete the Addendum #1 if Operated Location, Participating Franchisee, or Sub-Franchisee chooses to rent or purchase a FD-150 terminal for use as a "Gift Card only" terminal (no processing).

Step 9. On the first line, enter today's date. On the third line, enter date Participation Agreement was signed (see step #2). These two dates do not need to be the same.

• On page 2, Section 2, Election, mark your choice (Purchase or Rental). If you select Step 10. Purchase, we suggest you also select the Equipment Replacement Program to cover your Terminals in case of malfunction.
• On page 3, enter the legal entity name of the Operated Location, Participating Step 11, Franchisee or Sub-Franchisee on the first line. On the remaining lines, sign and enter your name, title, street address, city, state and zip code of the legal entity along with the date Addendum #1 is signed.

Source: Item 17 — The following paragraph is added to the end of Item 17 of the Disclosure Document: (FDD pages 70–378)