Fastpitch Legends​

​of the Greater Houston Area

Print this form, bring it with you to our event, email or mail it in with your contribution payment

MEMBERSHIP FORM

Fast Pitch Legends of Greater Houston Area
MEMBERSHIP ORDER FORM

Name:______________________ Address:___________________________ City:______________State:_____ Zip__________ 

Phone:_________________ Cell:________________________ Email: _______________________________________________

We accept Checks, Visa, Discover and MasterCard.  If paying by Checks Please make your Check payable to: Fast Pitch Legends and you can mail your payment to : Dorian Burdick P.O. Box 420069, Houston, TX 77242; you can email credit card payments to DorianSnyderBurdick@gmail.com
Credit Card Type:____________  Name on Credit Card: _____________________________ Credit Card No: __________________________

Exp. Date: __________ CVV: _______ Personal Card:______ Business Card:_____  Billing address for credit card if it is different from your mailing address: Name: ____________________  Address:____________________ City:_____________  State: _______ ZIP:________  A receipt will be emailed to you when you pay by credit card. 
Donation for Membership is $100) : _________                                         
Donation Supporting Fast Pitch Legends of Greater Houston Area: $ ___________

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 PAYMENT RECEIPT

Any questions regarding Your Membership and/or donations Ask: Dorian Burdick Cell: 713-784-9515 Email: DorianSnyderBurdick@gmail.com
Lifetime Membership Donation:  ___________    Support Donation: ______________________

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Note: We are now a Non-profit 501(c)(3) any monies are considered a donation

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