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YM Program Payment

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  Billing First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Billing Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Billing Email REQUIRED Please fill out this field. Please enter an email address.
  
  Billing Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Teen Participant First and Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Youth Ministry Program ie: PATHS 1, PATHS 2, Kairos, Summer Mission Trip etc REQUIRED Please fill out this field. Please enter valid data.
  
  Today's Date REQUIRED Please fill out this field. Please enter a date.
  
  Enter Payment REQUIRED
  3.2% for Credit Cards; 1.2% for ACH charges
  $ Please fill out this field. Please enter a positive decimal.
  
  Would you like to help offset online payment processing fees? REQUIRED
  3.20% for Credit Cards; 1.2% for ACH charges
  Yes, I can help - Credit Card only Yes, I can help - ACH only No, I do not wish to offset the processing fee Please fill out this field.
  
  Total:
  
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