Chicago Mission AAA Hockey
Registration Payment Form
 Posted 04/21/2010 12:45 PM

 YOU MUST PRINT THIS FORM!

**IMPORTANT**
 Your registration will not be complete until we receive your payment information!

Payment Information:  

Player Name:     Contact Phone#:  

E-mail:    

Registration for:   Spring '10          

Payment Method:         Amount Paid:    (see below)
Credit Card Information:

Card Number: Exp Date:    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)


YOU MUST PRINT THIS FORM!

PAYMENT AMOUNT
 (all payments are non-refundable)
Spring Tryouts  $75   $50 for returning Mission players (Squirt, Pee Wee, and Bantam's - NOT 97's)
Spring Boys Program  $550  $500 for returning Mission players
Spring Girls U10 - U19  $360  $320 for returning Mission players
Spring Midget Prep Camp   $575  $525 for returning Mission players ($350.00 non refundable deposit fee is required with Application)

NON-REFUNDABLE

Make your check made payable to:
Chicago Mission

Complete and print this form and mail to:

Chicago Mission Registration
6690 S. Route 53 St.
Woodridge, IL  60517

or fax it to 630-521-1150

 

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