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Online Order Form


Sign Up for a Play Like a Pro Sports Clinic

 Accepted

 

 

 

 

 

 CUSTOMER BILLING INFORMATION

     
First Name:  
Last Name:  
Address 1:  
Address 2:  

City, State:

                                       
Zip code:  

Phone:

(333-444-5555)

 
Emergency Phone:  
Fax:  
Email Address:  
     

 STUDENT ATHLETE INFORMATION

Please Fill this Section out with the Information about the student who will be attending the

clinic at Play Like a Pro.  For Dodge Ball Sign-ups, please give us the names of the players on your team under (Misc. Information)

First Name:  
Last Name:  
Age:  
Birthday:          
Email:  
Sport(s) Played:  
     
Misc. Information:  

 WHICH CLINIC ARE YOU INTERESTED IN PURCHASING?

 This is the amount your credit card will be charged. (Including Tax)

     

AVAILABLE LITTLE SLUGGERS PROGRAMS

 


AVAILABLE SPORTS BASH CAMPS AND CLINICS

 


AVAILABLE SUMMER CAMPS & CLINICS

Enter Discount Code:  
 

CUSTOMER PAYMENT INFORMATION. 

**Please Note, The Credit Card you provide must match the billing address stated above.  For any questions, please contact us anytime.

     
Credit Card Type:  
Credit Card #:   (Enter without spaces)
Name on the Card:  
Expiration Date:                                                   
3/4 Digit Security Code:  
     
How did you hear about us?  
     

 

This Form will be sent directly to a sales representative to be processed right away. 

If  there is any problems, you will be contacted shortly.  Play Like a Pro Baseball does not

disclose your information to third parties.

 

PLEASE NOTE! By clicking the submit button below, you agree that if in any case you wish to

cancel the requested clinic, $50 will be with held from the amount refunded to you as long as

your cancellation notice is received prior to 10 days before the clinic is to begin. 

Any student wishing to cancel a clinic within 10 days prior to the clinic being started

will not receive any refund or credits.

 

 

©2010 Matt Guiliano's Play Like A Pro. All Rights Reserved
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1745 Express Drive North Hauppauge NY, 11788 Phone: (631)342-9033 | Fax: (631)342-0408

 

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