Adult Custom & Lesson Payment

On-line Payment for Pass Academy Lessons and Adult Programs at Potomac Swim & Tennis Club

"*" indicates required fields

Name*

First Last

Address*

Street Address City State ZIP Code

Email Address*

Enter Email Confirm Email

Phone*

Lesson Dollar Amount

Price: $1.00

Enter DOLLAR AMOUNT as instructed by Pass Academy staff.

Lesson Pro's Name

Other Lesson Pro's Name

Gratuity Dollar Amount

Price: $1.00

Enter optional dollar amount for a pro.

Gratuity Pro's Name

Other Gratuity Pro's Name

Custom Dollar Amount

Price: $1.00

Enter DOLLAR AMOUNT as instructed by Pass Academy staff for a custom purchase.

Total Fees

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Additional Information (optional)

A Submit button will appear below when the Total Fees from your selections above are greater than $0.

Total-Fees