Alternate Payment Form | Lamplight Artists

Use this form if you need to pay fees, order t-shirts, or to submit other payments. Simply complete the form below and click ‘Make Payment.’

Name
First Last
Address*
Street Address City State ZIP Code
Email*
Camp Location?*
What are you paying for?*
Registration payments*
One student name per line please
Total Registration Payment Amount*
Enter the total amount you should pay for registrations
If other, please describe*
Please describe what you are paying for
Payment Amount*
Enter the amount you've been asked to pay
How Many T-Shirts?*
Student 1 Name*
Student 1 T-Shirt Size
Student 2 Name*
Student 2 T-Shirt Size
Student 3 Name*
Student 3 T-Shirt Size
Student 4 Name*
Student 4 T-Shirt Size
Student 5 Name*
Student 5 T-Shirt Size
Payment Options*
Credit Card*

Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00