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Thank you for becoming a part of our Golf Replay program!
To pay safely and easily with Paypal, click on the PayPal Button below.
To pay by check or money order, please print this page and fill in the information.
Mail to:
Golf Replay Group
P.O. box 1484
North Myrtle Beach, SC 29598
Purchase
( ) Single $34.00 ( ) Double $54.00 ( ) Foursome $74.00
Plus $5.99 SH/&P TOTAL $____________
Payment Type
( 1 ) PayPal Payment System-(Coming Soon)
( 2 ) Personal Check_________
(Print Form and Send in With Check or Charge Card Information)
( 3 ) ( ) Visa ( ) Master Card ( ) AMEX ( )Diners Club
Card Holder ______________________________________
Card Number ______________________________________
Expiration Date ____________/____________
Mailing Address
Street ____________________________________________
City ______________________________________________
State _______________________ Zip__________________
(Printing Page 2)
Credit Card Billing Address
(If Different From Mailing Address Above)
Street: _________________________________________
City: ___________________________________________
State: _______________________ Zip: ______________
Contact Info
Name: _______________________________________
Email: _______________________________________
Day Telephone: ( ) __________ ___________
Evening Telephone: ( ) __________ ___________
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