Adult Payment

On-line Payment for the Pass Academy

Use this form to make a payment for an adult clinic or lesson.

"*" indicates required fields

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Email Address*

Enter Email Confirm Email

Phone*

Private Lesson Amount

Price: $1.00

Enter the dollar amount and press the Enter key

Pro's Name (required)

Gratuity

Price: $1.00

Enter optional dollar amount for pro.

Clinic Dollar Amount

Price: $1.00

Enter the dollar amount and press the Enter key

Total Payment

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Additional Information (optional)

A Submit button will appear below when the Total Fees from your selections above are greater than $0.

Total-Fees