Pizza Friday

Child's Name
First Last
Second Child's Name
First Last
Pizza*
- One Slice-$2.00
- Two Slices-$4.00
- Four Slices-$8.00
After School Program Location*
- Bayville Community Center
- Locust Valley Reformed Church
Parent/Guardian Name
First Last
Phone*
Email*
- I would like to pay the credit card fee associated with processing this gift! (Fee equals 2.9% of your contribution, plus 10 cents per transaction.)
Credit Card Processing Fee
Price: $0.00
Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
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