Southside: Tournament payment 2019 This form is secure. Parent/Guardian InformationParent/Guardian Name* First Last Email* Phone*Player InformationName* First Last Payment InformationAre you using fundraising funds to offset your tournament fees?*YesNoSouthside Tournament Fee*MLK Tournament: 16 Black (Coach Cammy) - $136MLK Tournament: 16 Orange (Coach Marysia)- $143Mac Jr's & Game Day Tournament: 14 BlackPNQ - 16 Black: $228PNQ - 16 Orange: $182This is a one-time payment for a tournament fee.Please enter the balance you owe after fundraising.* Total $0.00 Credit Card* DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name
