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Individual Registration

Please enter information in the form below to process registration for event Nov 8 | 10:00-11:30 am | Livermore Fusion Soccer Club Gives Back.

First Name  *

Last Name  *

Phone  *

Email  *

PAYMENT: On the final PAYMENT screen of this registration you will select one of these payment options:

1) Pay at the event itself (Pay Later)
2) Pay online now with PayPal (using either your PayPal account or a credit card)

If you expect to pay with PayPal, would you also like to cover PayPal's 3% transaction fee, so Kids Against Hunger gets 100% of your donation?

PayPal Fee  *

Yes

No

Payment Information

Amount

$

Payment Method *

Paypal Pay Later

Credit Card Number*

Expiration Date*

01 02 03 04 05 06 07 08 09 10 11 12 / 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036

Card (CVV) Code*

Card Holder Name*

Terms and Conditions *

By registering for this event, I accept Terms and Conditions