-The following information will be needed to complete your Charge Payment.
-Complete the worksheet below and click submit to send the information to IPV for processing. 
-We will confirm receipt by email within 24 hours.
-This is a secure webpage as indicated by the https:www...
-If you prefer, you may also call Patti at 630-969-8041with information or set-up time to run card at Walker.

Player Name:    

Player Team:    

Parent E-Mail Address:

Address: City: Zip:

Phone #:

Charge Card #:  Expiration

Signature on card: 

Reason for payment (dues, uniform, apparel, lesson, clinic, travel, etc.):

*Please indicate travel type: Dunes (IN), Dells (WI), MEQ (Indy), JVA (Louisville), AAU (Orlando), Asics (Navy Pier)

*All charge payments reguire a 2.7% processing fee.
This fee must be added to the amount of your payment total to be accepted. 
Amount of payment + 2.7% processing fee:  .

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