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2017 Fall Team Tournament - SAC Account Charge Copy

Use this form if you would like to charge your registration and other fees to your Seattle Athletic Club (SAC) account. Please note that by submitting this form you authorize Seattle Urban Squash to charge your SAC member account the dollar amount designated on this form. Please contact with any questions. 

Contact Information

First Name
Last Name


Provide your mobile/landline number for contact

Address Line 1
Address Line 2
ZIP/Postal Code

Provide you club account number to be charged to.