Retailer/Restaurant Sign Up

Please fill out the online form below or download the Retailer Agreement form below and email or mail it back to the address on the form.

2026 Shop With Heart Card Agreement Form – ADA Download

Click HERE to donate & participate

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

Local Store Name (as it will appear in printed materials) *

Local Store Address (as it will appear in printed materials) *

Street Address Address Line 2 City State ZIP Code

Website *

Local Store Phone Number *

Local Contact Name/ Title *

Local Store Contact Email *

Business Listing Description

Please provide below a maximum 20-word description of store merchandise, noting exclusions, as it should be listed in the Shop With Heart Card. The Heart Guild/The Shop With Heart Card reserves the right to edit final wording.

Description *

If you would like to use the same description as last year, please type “last year”

Exclusions

Business Category Listing *

Shopping Area *

Please list the shopping area below that best describes where your business is located. (Each store will be listed under 1 location)

Sell Shop With Heart Cards

We ask that each store consider the SKU Card Sales process as it secures that funds are collected when the purchaser receives the card and benefits and a seamless transition transaction at the end of the event. Please select the sales process you prefer to use for processing Card sales.

Please select the sales process you prefer to use for processing Card sales *

Participation includes selling two (2), $75 Shop With Heart Cards or submission of a $150 participation fee if not selling cards on-site. *

Please select from options below. Payment link is at the top of this form.

Purchase 2 Shop with Heart Cards

Donate $150

Sell 2+ Shop with Heart Cards

Terms and Conditions *

I agree

This agreement confirms our participation in the 2026 Shop With Heart Card fundraising event and acknowledges our agreement to the terms and conditions stated below: • • We acknowledge that AHA retains all proceeds from SWHC sales. • Participation includes selling two (2), $75 Shop With Heart Cards or submission of a $150 participation fee if not selling cards on-site, to support the overall card sales benefitting the American Heart Association. • We are responsible for all cards sold, lost, or stolen. Each card is valued at $75. A volunteer will contact you regarding any unsold or unused Shop With Heart Cards or materials by May 18,2026. • We agree to sell and promote the Shop With Heart Card during the 10-day fundraising event from Friday, May 1, through Sunday, May 10, 2026. This includes displaying provided materials: posters, brochures, and other marketing items. • We understand the Shop With Heart Card is non-transferable, and we will request photo identification to ensure only the person whose name appears on the materials, is using the Card. • We agree to advise all store personnel of these conditions and to promote the sale of Cards. • We agree not to run a store-wide promotional discount on regular priced merchandise where the discount nullifies or competes with the Shop With Heart Card discount during the 10-day fundraising event. • We agree to honor the 20% discount on all regularly priced store merchandise for Shop With Heart Card holders unless the merchant is under a contractual agreement prohibiting such a discount on specific merchandise. • The Shop With Heart Card 20% discount cannot be combined with other offers and does not apply to: sale items, gift certificates/cards, layaway payments, online purchases, previous purchases, special orders, or restricted merchandise. • All exclusions, if any, are noted on the front of this Shop With Heart Card Participation Agreement. • Lost or stolen Shop With Heart Cards will not be replaced, and we understand the American Heart Association and Heart Guild of Houston will not replace lost or stolen Cards.