Breakaway Payments

Secure Online Event Registration

Payment Type*

Student Registration Payment
For students wishing to pay the remainder or complete Registration Cost.
Student Scholarship
For someone wishing to make a tax-deductible donation towards schalarshipping a student to go.

Payment Amount*

$

Recurring*

One Time

Add 3% to my registration to cover credit card fees.

Total

$0.00

Student Name*

Student Email*

Student Phone Number*

Gender*

Male
Female

Billing Information

Name*

Payment Method

Credit Card
Check/ACH
Give cash to CL leader

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

Phone Number*

This page is secured with 256 bit encryption

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Fundraising Software by GivingFuel