Mock Trial Team Registration Form for Credit Cards

The deadline to submit this form is 4:30 pm on February 3, 2025. After submitting this form, your credit card will be charged $165 ($160 registration and $5 administration charge)

If you have any questions, please email Kim Furr.

School

School Name *

Street Address *

City *

County *

State *

ZIP/Postal Code *

Phone *

Primary Contact

Teacher Coach Name *

Teacher Cell Phone *

Teacher Email *

Additional Coach Contacts

You may provide up to three additional contacts.

Additional Coach Contact 1

Name

Cell Phone

Additional Coach Contact 2

Name

Cell Phone

Additional Coach Contact 3

Name

Cell Phone

Payment Information

Name as it appears on the card *

Credit Card Number *

Expiration Month *

Expiration Year *

Leave this field blank