5. BAXTER JACK'S LOUISVILLE YOUTH BEACH BASH - JUNE 24TH & 25TH
DEADLINE FOR ENTRY IS THURSDAY, JUNE 22ND
*
Required Fields
CAPTAIN'S NAME:
*
YOUR NAME(if not Capt):
TEAM NAME:
*
ADDRESS:
*
CITY:
*
STATE:
*
ZIPCODE:
*
WORK PHONE:
HOME PHONE:
EMAIL:
*
SELECT A DIVISION:
DOUBLES - 12U Doubles
DOUBLES - 14U Doubles
DOUBLES - 18U Doubles
DOUBLES - 16U Doubles
QUADS - 14U Quads
QUADS - 18U Quads
QUADS - 12U Quads
QUADS - 16U Quads
DIVISION NAME:
12U Doubles
DIVISION CODE:
DOUBLES
DAY:
Sunday, June 25th
OPTIONS:
12U Doubles
($40.00)
14U Doubles
($40.00)
18U Doubles
($40.00)
16U Doubles
($40.00)
12U Quads
($80.00)
14U Quads
($80.00)
18U Quads
($80.00)
16U Quads
($80.00)
TOTAL:
$80.00
PAYMENT TYPE:
Credit Card
PAYMENT INFO:
Name On Card:
Credit Card Number:
Credit Card Type:
MASTERCARD
VISA
AMERICAN EXPRESS
DISCOVER
Expiration Date:
January
February
March
April
May
June
July
August
September
October
November
December
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
CVV Code:
Captcha:
Select 2nd, 4th, 5th, Checkbox.
Thank you for your tournament entry and payment. We will be processing your credit card in the next several days. Your credit card receipt will read Baxter Jack's. If you have any questions, feel free to contact us at 502-582-3530.