Pay Your Dues Online

REGISTRATION FORM  (Please complete all fields.)


Name     

Address



City      State              Zip

Phone #     E-mail


What is your team's name, if you have one?


Team Members (include T-shirt size, indicate Adult or Child)


NAME & AGE IF UNDER 13      T-SHIRT SIZE

NAME & AGE IF UNDER 13 T-SHIRT SIZE

NAME & AGE IF UNDER 13 T-SHIRT SIZE

NAME & AGE IF UNDER 13 T-SHIRT SIZE


REGISTRATION FEE DUE FOR ALL TEAM MEMBERS (Mastercard, Discover, Visa, or Check) $25 per person, but only $15 for those under 13 yrs. old

TO PAY BY CREDIT CARD (Be sure address above is billing address.)


NAME AS IT APPEARS ON CARD


CREDIT CARD TYPE


CARD #


EXPIRATION MONTH & YEAR



3 DIGIT CODE ON BACK OF CARD


TO PAY BY CHECK

Please download the Registration Form, and mail it
along with your check to the address on the form.


[CLICK HERE TO DOWNLOAD REGISTRATION FORM]


[CLICK HERE TO DOWNLOAD A DONATION FORM]




REGISTRATION FORM  (Please complete all fields.)


Name     

Address



City      State              Zip

Phone #     E-mail


What is your team's name, if you have one?


Team Members (include T-shirt size, indicate Adult or Child)


NAME & AGE IF UNDER 13      T-SHIRT SIZE

NAME & AGE IF UNDER 13 T-SHIRT SIZE

NAME & AGE IF UNDER 13 T-SHIRT SIZE

NAME & AGE IF UNDER 13 T-SHIRT SIZE


REGISTRATION FEE DUE FOR ALL TEAM MEMBERS (Mastercard, Discover, Visa, or Check) $25 per person, but only $15 for those under 13 yrs. old

TO PAY BY CREDIT CARD (Be sure address above is billing address.)


NAME AS IT APPEARS ON CARD


CREDIT CARD TYPE


CARD #


EXPIRATION MONTH & YEAR



3 DIGIT CODE ON BACK OF CARD


TO PAY BY CHECK

Please download the Registration Form, and mail it
along with your check to the address on the form.


[CLICK HERE TO DOWNLOAD REGISTRATION FORM]


[CLICK HERE TO DOWNLOAD A DONATION FORM]



Name as it appears on credit card
Credit card mailing address
Credit card type (Visa, Mastercard, Discover Only)
Credit Card Number
Expiration Date
CVC Code
Amount of Charge