2020 YOUTH LEAGUE QUADS PAYMENT FORM
PAYMENTS ARE DUE!!!
  * Required Fields
CAPTAIN'S NAME: *
YOUR NAME(if not Capt):
TEAM NAME: *
ADDRESS: *
CITY: *
STATE: *
ZIPCODE: *
WORK PHONE:
HOME PHONE:
EMAIL: *
# Of Players:  
   
SELECT A DIVISION:
DIVISION NAME: 20 Under Boys
DIVISION CODE: QUADS
DAY: Monday
   
Player Entry Fee: 0 x 35.00 = $0.00
TOTAL: $0.00
   
PAYMENT TYPE: Credit Card 
PAYMENT INFO:
Name On Card:
Credit Card Number:
Credit Card Type:
Expiration Date:
CVV Code:
Thank you for your league payment for Baxter Jack's. 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.