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September 12th Co-ed Beach Dodgeball Tournament: Team Payment Form


Team Name :

CREDIT CARD HOLDER INFORMATION

* Full Information for yourself is mandatory


Full Name : *
Email : *
Contact # : *
Address : *
City: *
Postal Code : *

CREDIT CARD INFORMATION
Credit Card Type : *
Credit Card # : *
Expiry Date : *

PAYMENT AMOUNT

Total payment :
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arrow  Team Registration 
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arrow  2010 Fall - $200 Team Deposit Form 
arrow  2010 Fall Team: Online Payment 
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Located at 1875 Leslie Street
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