MACH HACH PAYMENTS

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone Number
Name of Camper
Please insert the name of the child you are registering for. A new form should be filled and separate transaction for each child registering.
Make a Payment*
- Registration Fee: $515 ($500+3%)
- January 1 Payment: $2,060 ($2000+3%)
- March 1 Payment: $3,090 ($3000+3%)
- Other
Other Amount

*Please add 3% to your total to cover online credit card processing fees or the office will add it separately.
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Please do not click submit more than once or your credit card may be charged twice.
Email
This field is for validation purposes and should be left unchanged.