JUVENTUS ACADEMY SAINT LOUIS: MYSA Card PAYMENT FORM 2020-2021

Welcome to the online MYSA Card PAYMENT FORM for the 2020/2021 seasonal year for JUVENTUS ACADEMY SAINT LOUIS.
 
CARD FEES:
Primary Player Card:  $25.00
Secondary Player Card:  $10.00
ADMIN Card (coach or TM):  $11.00
 
 
If you have any questions, please contact:
Kathy Powers | Vice President & COO
Cell/Text: (314) 570-7857
E-Mail: admin@juventusacademystl.com

TEAM INFORMATION

TEAM #1

Gender *

TEAM # 2

Gender

TEAM # 3

Gender

PAYMENT AUTHORIZATION

I would like my payment to be deducted using the following type of account: *
TOTAL AUTHORIZED PAYMENT *
 

NOTES

CHECKING / SAVINGS INFORMATION

eCheck Processing confirmation *

DEBIT / CREDIT CARD INFORMATION

Card Processing fee confirmation *

PAYMENT AUTHORIZATION

Please read and sign: *

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