Riders

For payment of your session fees by credit card, please complete the form below. If paying a custom amount, simply enter the amount of your payment in the "Other" field. At the bottom of the form, be sure to select the session number for your payment. Thank you!

Have questions? Please call our Business Office at (816) 808-1209.

Payment

$96.00 - Rider Co-Pay Session Fee
$384 - Self-Pay Rider Session Fee
Other

Other

Select Session for this Payment (Required)

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Name of Your Rider

Parent Name

First Name *

Last Name *

Email (Required)

Phone

Select a Payment Method

Credit Card
Bank Account

Cardholder Name (Required)

Credit Card # (Required)

Expiration Date (Required)

Security Code (Required)

cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

Billing Zip Code (Required)

Cover the fee associated with this online transaction?

Yes, I will pay an additional {transaction_fee} to cover the cost of this transaction.

Cover the fee associated with this online transaction?

Account Holder

First Name

Last Name

Account Type

Checking
Savings

Account Number (Required)

Routing Number (Required)

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

Variety KC
Sunderland
Mabee Foundation
Mariner Wealth
Hallmark
Patterson Foundation
Deffenbaugh

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