Captain Sports, Inc.
P.O. Box 178
Delaware, OH 43015-0178
888-5-Captain

1) Please complete the Credit Card Authorization form to add a new credit card to your account or update your existing credit card that is currently on file.
2) Print
3) Fax to 866-929-3318

Credit Card Authorization

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Company Name

Dealer Number (If Issued)

Company Name or Personal Name as printed on Credit Card

Credit Card Type
MasterCard
Visa

Credit Card Number

Expiration Date
 (MM/YY)

Credit Card Billing Address
Street Address

City, State, Zip Code

I _____________________________ (Company Contact) authorize Captain Sports, Inc. to charge the above credit card for dropship and bulk orders submitted via facsimile, e-mail, telephone and online at CaptainSports.com.