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Football Pool Payment

Submitted by bruce@sibro.biz on Wed, 08/21/2019 - 12:48

Thank you for participating in our Football Pool. You will be taken to a page where you can securely enter your credit card or use PayPal.

Ticket *

First Name *

Last Name *

Address *

City *

State *

Zip *

Date *

Month

Day

Year

Email *

Selecting the submit button will take you to our registration site.

Leave this field blank

Username *

Password *

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Math question * 1 + 0 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

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