FAN-tastic PASS

Name: _______________________________________________________

Address: _____________________________________________________

____________________________________________________________

Phone: ________________________________

High School Passes:

Adult: _________ x $40 = _____________

Student: _________ x $25 = _____________

Middle School Passes:

Adult: _________ x $30 = _____________

Student: _________ x $15 = _____________

Total Amount Due: $______________

Payment must accompany the order.  Make checks payable to Teays Valley Athletic Department.