2021 Belmont Bolt Order Form

This form is to register for the Belmont Bolt, which is FREE! You can also purchase a Belmont Bolt t-shirt if you would like one. Shirts are $8.00/shirt and only $5.00 for our Belmont staff! BONUS: You can also add a mask to your order for $5 (normally $8)! All shirts must be ordered and paid for no later than Wednesday, April 7th using paypal or check payable to Belmont PTA. Information on tshirt pick up will be forth coming so that you and your children can wear them during our Belmont Bolt week, April 24-May 2nd. Thank you!

Child/Family/Staff Name *

First Name Last Name

Parent/Guardian/Staff E-mail *

example@example.com

Payment Option *

Not purchasing items, just registering for the Belmont Bolt Paypal (to belmontptsa@gmail.com) Check payable to Belmont PTA (dropped to Belmont by 4/7/21)

When you hit submit you will be redirected to paypal to complete your transaction.

When you hit submit at the bottom of the form, it will automatically redirect you to paypal. Please just disregard the paypal page. If you see that page, your order was received.

Please list the names of your Belmont children who will be particpating in the Bolt this year:

Name

First Name Last Name

Name

First Name Last Name

Name

First Name Last Name

Name

First Name Last Name

Products: Click on the box next to products you would like to purchase to see sizes/quantities.

YOUTH Shirts Gildan 50/50 (cotton/poly blend)

$ 8.00

Size	Quantity
XS (4/5)
S (6/8)
M (10/12)
L (14/16)

Item subtotal: $ 0.00

ADULT Shirts Gildan 50/50 (cotton/poly blend)

$ 8.00

Size	Quantity
S
M
L
XL

Item subtotal: $ 0.00

STAFF T-Shirts Special Pricing for our Belmont Staff! Gildan 50/50 (cotton/poly blend)

$ 5.00

Size	Quantity
S
M
L
XL
2XL

Item subtotal: $ 0.00

ADD A MASK Add a Belmont Face Mask to your order for only $5! Youth and Adult sizes.

$ 5.00

Size	Quantity
youth mask
adult mask

Item subtotal: $ 0.00

Total

$ 0.00

We are thrilled to host our 2021 Belmont Bolt although it will look and feel different to maintain safety for our community. This year the Bolt will not be a fundraiser and will not be a one day event. More event details on our website at belmontespta.org.