4. BAXTER JACK'S FIRECRACKER SAND SPECTACULAR - JUNE 27TH
DEADLINE FOR ENTRY IS THURSDAY, JUNE 24TH
  * Required Fields
CAPTAIN'S NAME: *
YOUR NAME(if not Capt):
TEAM NAME: *
ADDRESS: *
CITY: *
STATE: *
ZIPCODE: *
WORK PHONE:
HOME PHONE:
EMAIL: *
   
SELECT A DIVISION:
DIVISION NAME: Coed C Sixes
DIVISION CODE: SIXES
DAY: Saturday, June 27th
   
OPTIONS: Coed C Sixes ($90.00)
TOTAL: $90.00
   
PAYMENT TYPE: Credit Card 
PAYMENT INFO:
Name On Card:
Credit Card Number:
Credit Card Type:
Expiration Date:
CVV Code:


Captcha: Select 1st, 2nd, 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.