SHED 2023 Summer Registration Payment FIX You may use this form to make a $75 payment for the SHED 2023 summer registration fee if you have already filled out the 2023 summer registration form. Parent/Guardian Name* First Last Child's Name* Child’s First Last Additional Child? – click the box below to add sibling information: Additional child? Child 2 Name First Last Additional child? Child 3 Name First Last Additional child? Child 4 Name First Last Contact InformationParent/Guardian Cell Phone*Parent/Guardian Email* (A receipt will be sent to this email address)Payment InformationSummer Registration Fee* Price: How Many Children Are Your Registering?*One ChildTwo ChildrenThree ChildrenFour ChildrenCredit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Payment ConfirmationTotal $0.00 Payment Authorization* I authorize this one-time payment. CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Δ
