NP2023 – Fuze Media Group

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Gymnast Name*
First Last
TEAM*
Parent/Guardian Name*
First Last
Parent/Guardian Email*
Parent/Guardian Phone*
Silver Package Quantity
1 - 8x10 Individual 2 - 5x7 Individual 1 - 5x7 Team
Price: $20.00
Gold Package Quantity
1- Memory Mate 1 - 8x10 Individual 2 - 5x7 Individual 1 - 5x7 Team Trading Cards
Price: $45.00
Trading Card Pack Quantity
Price: $15.00
8x10 Memory Mate Quantity
Price: $15.00
Digital Photo Individual Quantity
Price: $20.00
8x10 Team Quantity
Price: $10.00
8x10 Individual Quantity
Price: $10.00
5x7 Team Quantity
Price: $10.00
5x7 Individual Quantity
Price: $10.00
8 Wallets Quantity
Price: $10.00
4x6 Magnet Quantity
Price: $9.00
4 - Wallet Magnets Quantity
Price: $9.00
18x24 Individual Poster Quantity
Price: $15.00
18x24 Team Poster Quantity
Price: $10.00
Additional Notes
Total
$0.00
Payment*
- Online
- Cash or Check In Person
Billing Address*
Street Address Address Line 2 City State ZIP Code

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Cardholder Name

Card Details

FUZE Media Group INC
PO BOX 322
Fremont, MI 49412
(231) 335-1214