Victory Kid Sports Charitable Contribution / Tax Exempt

Name

This address will receive a confirmation email

Phone

Address

Is this a donation for the Bus Campaign?

Yes No

I would prefer to make a monthly gift (Or skip to the bottom for a one time gift)

I give permission to Victory to charge/debit my card every month. I understand that at anytime I can stop payment by emailing or sending a letter to Victory Yes

First Name on Card

Last Name on Card

Billing Address

Credit Card Type (Please check box) Visa Mastercard AmEx Discover

Expiration Date (Month/Year)

Card Identification Number (Last 3 digits on the back of card)

Amount to be charged monthly

I authorize Victory Kid Sports to charge the amount listed above to the credit card listed on this form. I agree to pay for this purchase in accordance to the issuing bank cardholder agreement (Please date and put your signature in the box to confirm you agree with this monthly transaction)

One-Time Donation Amount & Check Out

Donation Amount (Please enter your one time gift amount, after you enter the amount, please enter your credit card information below in order to check out)

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit.

Victory Kid Sports Charitable Contribution / Tax Exempt

Description

Please Fix the Following