5K GIVE AWAY VIRTUAL TICKET SUBMISION

TEAM INFO
SUBMIT YOUR TEAM INFORMATION

Please type in your team information below.
Your Name*

First NameLast Name
Email:*
example@example.com
Text/Cell:*

Area CodePhone Number
Team Name*
EX: WSA 05 Girls NPL Ken Richardson
Team Coach*
Head Coach Name
Team Year*
Please select from dropdown
Gender*
Please select from dropdown.
Community Club*
Please select from dropdown.
Your Team's League (note if you are not sure if you'll be OPC or NPL please guess)*

ENTER YOUR TICKETS PURCHASED & PAY
ENTER TICKET PURCHASED

Please KEEP YOUR COPIES OF ALL TICKETS SOLD! If a winning ticket is selected from your batch of entries, your copy of the winning ticket will be used to contact the winner. Hit the "plus" button to enter a new Ticket Purchaser, Email of Purchaser, and Quantity of Tickets purchased by that donor.
TEAM ROSTER & SIZE*
FINAL COUNTING

Add all the "quantities" together. Place that number below to calculate the amount to be paid. There is a processing fee of 1% added for the virtual submission.

TOTAL TICKETS SUBMITTED

$10 PER TICKET$10.00

PRICE PER TICKET (plus 1%).

Quantity
Item subtotal:$0.00

Subtotal $0.00Tax $0.00Total $0.00

CONFIRM YOUR ORDER

Please double check your math. Confirm your order by checking the box below to confirm your order and digitally signing your name as a team leader.
Please add any notes on any customers who donated via a Ticket Package:

CLEAN SHEET DONOR: $50 for 6 tickets
HAT TRICK DONOR: $100 for 13 tickets
GOAL CLUB DONOR: $250 for 30 tickets
GOLDEN GOAL DONOR: $500 for 65 tickets
CHAMPIONS DONOR: $1,000 for 140 tickets

Please note that at checkout your amount paid should reconcile with your total tickets AND ticket packages. This will ensure all of your donors are properly entered in the Drawing.
Please list any donors who donated via a "Ticket Package" by listing the donor name, and the Ticket Package.
Yes, I confirm I have double checked the math.*

I CONFIRM THIS ORDER
DIGITAL SIGNATURE TO CONFIRM ORDER*

First NameLast Name
SIGN DIGITALLY TO CONFIRM YOUR ORDER

Clear
TODAY'S DATE

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Date
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