DOMINICAN REPUBLIC WINTER BASEBALL TRIP
PLEASE FILL OUT ONE FORM PER PERSON.
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(*) indicates required fields |
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| * Passport number |
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| * Address #1 |
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| Address #2 |
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| * City State Zip |
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| * Home Phone |
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| * Cell Phone |
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| * Email Address |
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| Date of Birth |
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| * Sex |
M F |
Mail Check Made Payable To:
F.A.B.L.
(With printed copy of this form) |
PAYMENT OPTIONS:
Non Refundable Deposit Of $1,000.00
Dominican Trip
P.O. BOX 18
Kings Park, NY 11754
- or -
Credit Card Information |
| Credit Card # |
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| Expiration Date
(mm/yy) |
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| Card Type: |
Visa
MasterCard
American Express
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| Card security code (3 or 4 digit code) |
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| TOTAL CHARGES: |
1000.00 |
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Questions:
info@salsbaseball.com or 631 979-0528
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