CREDIT CARD AUTHORIZATION FORM

                     Organization Name

           Event Attending

    Number of Teams         Number of Participants 

                     Discover   Visa   MasterCard   American Express (Check One)

 Card Number

 Expiration Date:    CVV Code

Amount to be charged:   $ 

Print Name As It Appears On Card

Card holder’s phone number:

Billing Address of Card Holder

City/State/Zip

      Date Signed:

      Cardholder’s Signature*

* I hereby authorize US Cheer to charge the card referenced above in the amount given.

U.S. Cheer, PO Box 290037, Columbia, SC 29229       

 Phone: (803) 865-6844   Fax: (803) 865-6843