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Individual Order Form 400

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Contact
Payment
Delivery
CONTACT INFORMATION

Name and Email of Adult Contact

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ORDER SUMMARY
Product
Qty
Subtotal
YSG Monthly Enrollment
$28.00
Additional YCC Monthly Enrollment
$8.00
Total
$36.00
FUTURE PAYMENT
After today's payment, this card will be charged
$28.00 every 30 days
for YSG Monthly Enrollment
$8.00 every 30 days
for Additional YCC Monthly Enrollment

Change, Refund, & Cancellation Policy