Credit Card Registration Page

Fields marked * require an entry.

To help the event run smoothly please register your credit card beforehand using the checkbox below. You will not be charged unless you make a donation at the event. To register your card, please click the checkbox below and hit the "next" button. Then, fill out your contact and credit card information.

As a convenience, you may pre-register a credit card on the submission page to charge your purchases at event Free Clinic's 2022 Holiday Ball.

I authorize Free Clinic of Southwest Washington to use the credit card entered on the submission page at event Free Clinic's 2022 Holiday Ball. Once the transaction has completed successfully, a confirmation receipt will be sent to the email address entered.

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