Girls Clinic Payment

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<input type="hidden" name="cmd" value="_s-xclick">
<input type="hidden" name="hosted_button_id" value="YPPBB3P2S3WZ2">
<table>
<tr><td><input type="hidden" name="on0" value="Choose Clinic">Choose Clinic</td></tr><tr><td><select name="os0">
	<option value="Girls Golf Clinic (2 hrs)">Girls Golf Clinic (2 hrs) $90.00 USD</option>
</select> </td></tr>
<tr><td><input type="hidden" name="on1" value="Student's Name/Age">Student's Name/Age</td></tr><tr><td><input type="text" name="os1" maxlength="200"></td></tr>
<tr><td><input type="hidden" name="on2" value="Parent Contact Phone #">Parent Contact Phone #</td></tr><tr><td><input type="text" name="os2" maxlength="200"></td></tr>
</table>
<input type="hidden" name="currency_code" value="USD">
<input type="image" src="https://www.paypalobjects.com/en_US/i/btn/btn_paynowCC_LG.gif" border="0" name="submit" alt="PayPal - The safer, easier way to pay online!">
<img alt="" border="0" src="https://www.paypalobjects.com/en_US/i/scr/pixel.gif" width="1" height="1">
</form>

(1)-310-709-6541

alanpacificgroup@gmail.com

Girls Golf Clinic