Chicago Mission AAA Fall 2011-12 Tryouts Posted 05/02/2011 02:31 PM
Payment Information: (Your registration will not be complete until we receive your payment information) Player Name: Birth Year 2001 2000 1999 1998 1997 Midget Minor U16 Midget Major U18 Girls U10 Girls U12 Girls U14 Girls U16 Girls U19 Contact Phone#: Email Address: Payment Method: Visa MasterCard Check Cash Amount Due: $150 All Players $125 Returning Fall 10-11 Mission Players Credit Card Information: Card Number: Exp Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2011 2012 2013 2014 2015 2016 2017 2018 3 Digit Code: Name on Credit Card: Address: City, State, Zip: Signature: ______________________________________________________ (Note: a 4% Service Charge will be added for all Credit Card Transactions)
Payment Information: (Your registration will not be complete until we receive your payment information)
Player Name: Birth Year 2001 2000 1999 1998 1997 Midget Minor U16 Midget Major U18 Girls U10 Girls U12 Girls U14 Girls U16 Girls U19
Contact Phone#: Email Address:
Payment Method: Visa MasterCard Check Cash Amount Due: $150 All Players $125 Returning Fall 10-11 Mission Players
Card Number: Exp Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2011 2012 2013 2014 2015 2016 2017 2018 3 Digit Code:
Name on Credit Card: Address: City, State, Zip:
Signature: ______________________________________________________ (Note: a 4% Service Charge will be added for all Credit Card Transactions)
TRYOUT FEE: $150 (All Players) $125 (Returning Fall 10-11 Mission Players) * Pre-Registration ends the at 2:00pm the last business day before the 1st try-out NON-REFUNDABLE (Jersey Included)
Make your check made payable to: Chicago Mission
Complete and print this form and mail to:
Mission Fall Tryouts Andrea Hahn 6690 S. Route 53 St. Woodridge, IL 60517
or fax it to 630-521-1150
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