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South Florida Police Benevolent Association Event Form
South Florida PBA Domino Tournament REGISTRATION FORM
General Info:
Team Name
(Required)
Email
(Required)
Main Team Point of Contact Email Address
Number of Players (In Team)
(Required)
1 (One)
2 (Two)
Team Entry Donation
(Required)
Price:
Players:
Player 1 Name
(Required)
First
Last
Player 1 Email
(Required)
Player 1 Phone
(Required)
Player 2 Name
(Required)
First
Last
Player 2 Email
(Required)
Player 2 Phone
(Required)
Number of Non-Players
An additional $20 entrance fee applies per non-participants.
Non-Player Registration Fee
Price:
An additional $20 entrance fee applies per non-participants.
Total
Total donation including team registration and any non-participant registration
Signature
This authorization is for the South Florida PBA Domino Tournament Team Entry and processing fee. By signing, you authorize Dade County PBA / Love Fund to charge my credit card above for agreed upon purchase.
Date
MM slash DD slash YYYY
Rules Consent
(Required)
We agree to the rules and regulations set forth by the South Florida PBA
Payment Method
PayPal Checkout
Credit Card
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
