Raffle Ticket Payment

Chicago Mission Raffle Ticket

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Raffle Ticket Payment

Chicago Mission Team*
Player*
First Last
Raffle Tickets
50 Raffle Tickets at $10/ea ($500 TOTAL)
Total Payment Amount*
This is your payment for unsold tickets.
Please enter a number from 0 to 500.
Payment Type*
Credit Card
Payment Amount
This is the total amount due for unsold tickets.
Price: $0.00
Credit Card Processing
All payments defined above will be done with your Credit Card information provided here. Any declined transactions will result in a $30 fee.
All Credit Card information will be kept confidential.
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Authorization*
I herby authorize the Chicago Mission Hockey Club to charge my Credit Card or Bank Account on the dates defined above.
Signature*
Authorization Name*
Email Address*
For Receipt

Date*
Date Format: MM slash DD slash YYYY

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