Registration Payment

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Payment Method *

You selected an in-office payment option. Please submit this form and arrange payment with the Dolton Bears office.

Parent Name *

First

Last

Email *

Player Name *

First

Last

Full Name Payment

Programs *

Payment Options *

Football Full Payment

Price: $300.00

Football Installment payment

Price: $100.00

Cheer Full Payment

Price: $400.00

Cheer Installment Payment

Price: $150.00

Total

$0.00

Square *

Card

Name on Card

Coupon

123 Example Street

San Francisco, CA 12345

Monday—Friday

8am — 6pm

hi@example.com

(123) 456-7890

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