Individual Registration

Please enter information in the form below to process registration for event Boys & Girls Basketball State First Round @ Piute.

Ticket Type	Price	Available place
Students-With-Activity-Card Students With Activity Card	$3.00	Unlimited
K-6-Students K-6 Students	$3.00	Unlimited
Students-Without-Activity-Card Students Without Activity Card	$5.00	Unlimited
ADULT Adults	$5.00	Unlimited
UHSAA-PASS UHSAA Activity Pass (Must Be Shown At Door)	$0.00	Unlimited

First Name *

Last Name *

Address *

Address 2

City *

Zip *

State

Phone

Email *

Comment

Amount

Payment Method

Square

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*