Richfield Area Chamber of Commerce
             
12U and 14U Divisions.   ASU Rules will apply
June 8-9, 2018   -  Richfield, Utah
For more information please contact:   Ric Roberts  435-893-1693
Each team will need to bring 4 new softballs!

 
Head Coach's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
 
Division
Team Name
 
Team Entry Fee:   $400.00   Item Subtotal:  
$400.00
 
Total:
$400.00
 
Payment Information
Method of Payment:
Convenience Fees: Credit cards: 2.5% ($1.50 min)
                    (+1.5% convenience for foreign cards)
eChecks: $0.55
Update name from Head Coach's Information
Name of Individual
on Checking Account:
Name of Individual
on Savings Account:
Name of Business
on Checking Account:
Bank Routing Number:
Bank Account Number:
Credit Card Number:
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Head Coach's Information
Cardholder's Name:
Billing Street:
Billing ZIP/Postal Code:
 
Please be aware that payments will reflect on your statement as 
Instant Payments, Clinton UT 800-764-0844!!
 

Informed Consent and Release: Important, this is a legal document, read carefully.  Each of us, the undersigned players/coaches, acknowledge, agree and understand to participate and hereby assume all risks of injury or loss incurred or suffered while and/or upon the premises of the City of Richfield and Richfield Area Chamber of Commerce, its agents, associates, employees or anyone connected with the City of Richfield and Richfield Area Chamber of Commerce may claim, damages, costs or cause or action which I have or may in the future have as a result of injuries or damages sustained or incurred while and/or upon the premises of the City of Richfield.  I the undersigned player/coach, acknowledge that I have read and understand the above.

 
I Agree
I have read and understand the Informed Consent and Release
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