Online Payment

YOUR PAYMENT WILL NOT BE PROCESSED AND YOU WILL NOT BE REGISTERED FOR A COURSE UNLESS YOU HAVE CALLED THE SMOKING BARREL, LLC AT (308) 575-0246 AND VERIFIED THAT THE COURSE DATE IS AVAILABLE PREVIOUS TO SUBMITTING YOUR PAYMENT INFORMATION.

BY SUBMITTING THIS PAYMENT FORM YOU ARE AUTHORIZING THE SMOKING BARREL, LLC TO PROCESS YOUR ONE-TIME CREDIT/DEBIT CARD PAYMENT. THANK YOU.

Course Date You Are Signing Up For (example Jan. 7, 2017) *

Security (CVV) Code: *

Are you or your spouse past or present Military? *

Number of people being paid for: *

STOP!

DO NOT FILL OUT AND SUBMIT THIS FORM UNTIL YOU HAVE CALLED THE SMOKING BARREL, LLC AT (308) 575-0246 AND VERIFIED THAT THE COURSE DATE IS AVAILABLE.

Email: *

Expiration Date: *

Credit/Debit Card Number: *

Name as it appears on credit/debit card: *

ZIP Code: *

The Smoking Barrel, LLC

Card Type: *

"a SHOT ABOVE THE REST"

Street Address (No P.O. Boxes) *

Telephone Number: *