Payment Form

Thank You For Pre-Registering!

You can use this form to pay for your pre-registration. All contributions will go to cover the facility's rental fee and F&B expenses only. Everything left over will be contributed to Fort Worth Central Office. You can use this form to pay for your registration and any additional contribution you would like to make (e.g., scholarships).

MINIMUM SUGGESTED CONTRIBUTION: $12.00

Please note if using a credit card, there will be a 2.9% + 30¢ per transaction processing fee added to each payment made using this form.

If you would prefer to not use this form (so you don't have to pay the transaction fee), use your phone to scan this QR code to pay via Venmo.

The account name will show as "Rick W..." If asked, the "last four" phone of the phone are "0722"

Your Information

Your Name(Required)

First Last Name

Home Group(Required)

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile Phone(Required)

Email(Required)

Payment Information

This payment is for(Required)

My Registration Only

My Registration + Scholarship(s)

My Registration + Scholarship(s) + Other

Payment Amount(Required)

Transaction Fee

Price: $0.00

(Fee to process the credit card transaction)

Total

Credit Card(Required)

Card Details

Cardholder Name

Additional Comments

35073