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Equipment Rental Processing Form
 
   
 
    1. Fill in the information below.  
       
Player's Name      
Name of Cardholder      
Credit Card Number      
Expiration Date       Security Code          
Email Address      
Home Phone      
Billing Address      
City     State   Zip Code      
       
       
    2. Rental request.  
   
Package B:   $35

Helmet

Shoulder Pads, Elbow Pads, Gloves

Purchasing Package A & B: $60

 
 
       
    Please note: Equipment is issued to players before their first clinic and is collected after their last clinic. The cardholder must be present when equipment is issued to sign a liability contract for the full value of the rented material.  
       
       
       
    3. Submit your registration form.  
   
 
 
       
    Authorize.net  
       
   
 
 
     
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