Email *
Last Name: *
First Name *
Phone Number: *
Name on credit card being used for payment *
Please enter the Name as it appears on the card that you will use to make payment in the next step. Also indicate if the name on the card is different than the name of this registration. Example: "John Smith for Sally Smith"
Make your $60 payment after you click 'Submit'.
The next window that appears contains the link for you to click on to make a secure registration fee payment.
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