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CREDIT CARD PAYMENTS FOR DEPOSIT
If anyone would like to charge their deposit on a credit card, we accept VISA, MasterCard, American Express or Discover. Below list
the person wishing to charge, their credit card number, expiration date and amount to be charged along with their signature.
*WE MUST HAVE YOUR FULL BILLING ADDRESS IN ORDER TO PROCESS A CHARGE.
____________________________________________________________________________________________________________________________
Card Holder Name
____________________________________________________________________________________________________________________________
Billing Address (city, state, zip)
____________________________________________________________________________________________________________________________
Team/School Name
____________________________________________________________________________________________________________________________
Team/School Address (city/state/zip)
VISA
MC
AMEX
DIS Exp. Date _____ /_____ /_____
Card #
oooooooo oooo oooo
CVV (Security Code): ___________
Amount Charged _______________________________________
o
Deposit
o
Full payment
Signature ____________________________________________________________________________________________________________________
Daytime Phone # (_______)______________________________________ Cell Phone # (_______)____________________________________________
Email Address_________________________________________________________________________________________________________________