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Individual Registration

Individual registration

Name:
Address:
City:
State:
Zip code:
Email address
T-shirt size:

Billing information

Cost per player: $65.00
Credit card
Card Number:
Expiration month:
Expiration year:
Name on card:
Billing address
Street address:
City:
State:
Country:
Zip:
Please review the entered information before pressing submit.