coast to coast baseball tours
 

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Great C2C Merchandise!

 
program
forms

Printable MS Word Version

Coast to Coast Baseball Credit Card Authorization Form

Cardholder’s Name____________________________________________________

Name of person(s) traveling_____________________________________________

Circle One: Visa MasterCard Discover

Account #: _________________________________________________________

Exp. Date________________ Today’s Date________________


*Please Choose One of the Following Methods of Payment:

One-Time Charge:
I authorize Coast to Coast Amateur Athletics, Inc. to make a ONE TIME CHARGE $________________ (amount) to my credit card listed below for my/my child’s participation in the Coast to Coast Baseball program. I have read and understand your cancellation and refund policy. I also understand my billing statement charge will appear from “Coast to Coast Athletics” for the amount above.

Cardholder Signature__________________________________

Date: ________________

Multi-Pay Option:
I authorize Coast to Coast Amateur Athletics, Inc. to charge the following credit card EACH TIME A PAYMENT IS DUE (as outlined on the Rates and Payment Schedule Sheet) for my/my child’s participation in the Coast to Coast Baseball program. I have read and understand your cancellation and refund policy. I also understand my billing statement charge will appear from “Coast to Coast Athletics” for the amount above.

Cardholder Signature_________________________________

Date: ________________

Please complete and FAX (740-373-7465) or mail this form to:

Coast to Coast Baseball
PO Box 389
Marietta, OH 45750

Special Note: If you typically do not make purchases this large with the card listed above you may wish to call and alert your card company to this upcoming charge. Many companies now have anti-fraud policies that automatically decline larger-than-usual charges.

 


Coast to Coast Amateur Athletics * P.O. Box 389 * Marietta, OH 45750
PHONE 928-854-9455 * FAX 928-854-6669

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