Quadrant Hockey Payment

Quadrant Hockey
Name*

First NameLast Name
Email*
example@example.com
Team Name*
Invoice #*
found in confirmation email
To pay by Autodeposit E-Transfer:

Please send payment, including tax, to:
rdragonette@blackstreetcapital.com

Please include your Team Name, Age Group, and Event in the memo line

Deposit: $565 ($500 + HST)
Full Amount: $4237.50 ($3750 + HST)
Remaining Balance: $3672.50 ($3250 + HST)
To pay by Credit Card:

Payment Options*

Full Amount

$3,750.00CAD

Deposit

$500.00CAD

Remaining Balance

$3,250.00CAD

Subtotal

$0.00CAD

Tax

$0.00CAD

Shipping

$0.00CAD

Total

$0.00CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: