ACTTI Payment Form
No Refunds after Dec. 16th
Coach's Name
First Name
Last Name
Team Name
Gym Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Select all that apply and choose number of athletes registered.
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Number of Athletes Registered
Price Increases to $175/Athlete after Dec. 11th
$
150.00
Quantity
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100
Number of Athletes for Synchro
$
30.00
Quantity
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2
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91
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100
Number of Athletes for HUGS
$
90.00
Quantity
1
2
3
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9
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Level Change Fee/Athlete
Changes Jan. 10th-22nd
$
15.00
Quantity
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40
Other
$
1.00
Quantity
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100
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