Fisherman's Club Online Contribution

Once you have registered online, we will send you an email confirmation. Please allow up to fourty-eight hours for process.

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Personal Info
First Name
Last Name
Address Line 1:
Address Line 2:
City:
Zip Code:
Phone Number:
Contribution For:	Fisherman's Club
Contribution Amount:
Payment Info
Credit Card Type:	Visa Mastercard
Credit Card Number:
Expiration Date:
3 digit Security Code:

ACKNOWLEDGEMENT / ELECTRONIC WAIVER

Once pressing the "Pay Now!" button, you acknowledge that you are sending an electronic contribution to the described event.

In addition, you agree to the following listed below, and you also acknowledge that you will receive an automatic email confirmation letting you know that you electronic registration was successful. Thank you!

Please review the following:

• You agree to be charged the designated amount described above for a contribution to the Fisherman's Club.

• You release Michigan Church of God State Office and the online website from any liabilities of this electronic form, etc.