Select a Sponsorship
*
Presenting Sponsor - $5,000
Coin Sponsor - $2,500
Final Table Sponsor - $2,500
River Table Sponsor - $1,500
Card Sponsor - $2,500
Ante Sponsor - $500*
Name
*
First Name
Last Name
Company
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Calculation
Payment Information
*
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( X )
USD
Description
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Card Type
*
Please Select
American Express
Discover
MasterCard
Visa
I hereby authorize
PediPlace
to charge my credit card in the amount of ${calculation}.
*
Submit
Should be Empty: