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Bitty Ball Basketball Class (Registration Form)

Session # 1 Dates: 11/13, 11/20, 12/4, 12/11, 12/18
Session # 2 Dates: 1/8, 1/15, 1/22, 1/29, 2/5
Session # 3 Dates: 2/12, 2/26, 3/5, 3/12, 3/19
Cost: $99
Choose your session. (1 or all)
Session    #1    #2    #3

Information about the player.
DOB
Player Name
ParentName
Address
City
St
Zip

How do we Communicate with you?
Home Phone:
Email:
CellPhone:

Pay By:    Check    Credit Card    *Payments

Credit Card Information
*Fill this section out below if you clicked to pay by credit card, otherwise just click I accept.
Credit Card Type
Credit Card Number
Expires
Card Security Code
Name
Street
City
State
Zip
 




I understand that I have signed up for Bitty Ball Class. I have committed to the progam. If I decide not to do the program. I must call and cancel 5 days before the first date to get a refund.

Checks are payable to Paye's Place

Thank You,




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