Name of person filling out this form.
Email address (confirmation will be sent to this address)
US tournaments require approval from LT, LDBA, OBA, as well as out of country insurance (provided by LT upon approval).
For Paypal or Other, please provide information or weblink below (Paypal payments take 3-5 business days to be processed.).
Name of Person/Association payment to be made to
Example: [email protected]
If you require something to be written in the Memo location on the cheque, please provide it here
Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.Maximum # Files: 2. Maximum File Size: 4MB.
Receipts or other necessary proof required for reimbursement.
For cheque payment.
** Please note that cheque payments will be made on Monday morning each week, please communicate this to the tournament.