Adult Clinic & Lesson Payment

On-line PAYMENT for the Pass Academy Adult Clinics or Lessons at the Bullis School

Use this form if you were requested by the Pass Academy Staff to make a payment.

Adult Clinic & Lesson Payment Form
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Email Address*
Enter Email Confirm Email
Phone*
Social Event
Social Event
Price: $30.00
Enter number of players. $30 per player.
Private Lesson
Private Lesson Dollar Amount
Price: $1.00
Enter DOLLAR AMOUNT as instructed by Pass Academy staff.
Pro's Name
JB, Kwame, Lee, Mike
Gratuity
Gratuity Dollar Amount
Price: $1.00
Enter optional dollar amount for a pro.
Pro's Name
JB, Kwame, Lee, Mike
Custom Amount
Custom Dollar Amount
Price: $1.00
Enter dollar amount as instructed by Pass Academy staff for a custom purchase.
Total Fees
$0.00
Credit Card*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Additional Information (optional)