Academy Member – Monthly

Terms:

3 Months for $134.95 then $49.95 / Month

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Age of goalie:* Age of goalie is Required

Goalie Skill Level:* Goalie Skill Level is Required

Highest level played:* Highest level played is Required

Username:* Invalid Username

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Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Terms: 3 Months for $134.95 then $49.95 / Month

Description	Amount
Academy Member - Monthly – Initial Payment	$134.95
Total	$134.95

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Academy Member – Monthly

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