KC Imagemakers LLC can now accept MasterCard or Visa as payment for Team and Action Photos. To take advantage of this feature, print out this form, fill it in completely and put it in your order envelope.

Charges will appear on your credit card statement as "Shop and Share Mall".

Shop and Share Mall is a web site that is maintained by KC Imagemakers LLC, and the owners have allowed us to use their merchant credit card account to offer credit card sales to our customers.

Name *_______________________________________________________________

E-mail Address *________________________________________________________

Phone number *_________________________________________________________

Address * ______________________________________________________________

City*__________________________________State*___________Zip*_____________

Credit Card* (Circle one)       MasterCard               Visa

Credit Card Number *______________________________________________________

CVV Number *_______________Expiration Date (MM/YYYY) ____________________

 Purchase amount to be charged to card *________________________

Description of Items purchased______________________________________________

Signature _______________________________________________________________

* Fields marked with an asterisk are required fields