Southeastern Track & Field Booster Club Application Form

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Date *

Date Picker

Email address *

First name *

Last name *

Address 1 *

Address 2

City *

State *

ZIP Code *

Cell Phone Number *

Relation to the Team (Check all that apply): *

Parent Alumni Community Member Business Sponsor Other (Please Specify):

Membership Level: *

The Green Ribbon ($25 - $15.00 Your tax deductible amount) The Pink Ribbon ($50 - $40.00 Your tax deductible amount) The White Ribbon ($75 - $60.00 Your tax deductible amount) The Yellow Ribbon ($100 - $80.00 Your tax deductible amount) The Red Ribbon ($250 - $195.00 Your tax deductible amount) The Blue Ribbon ($500 - $380.00 Your tax deductible amount)

Preferred Payment Method *

Credit Card Paypal Check

Please submit payments to the SCC Blaxkhawk T&F Venmo: Click Here

Agreement: *

Signature (Type your full name as an electronic signature):

Please review your information before submitting. By clicking "Submit," you confirm that all the information provided is accurate and that you agree to the terms and conditions of the Southeastern Blackhawks Booster Club.

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