Butler NYC Trip Protection Payment Form Placeholder

If you have not yet purchased Trip Protection, this is your last chance!

Student Name*
First Last
Parent/Guardian Name*
First Last
Email*
Enter Email Confirm Email
Trip Protection*
Price: $75.00
With Trip Protection, you will receive a refund of all payments made towards the trip. This does not include fundraising profit or the $75 you pay for Trip Protection.
Will you be paying with check or credit card?*
A 3% convenience fee is added to credit card sales.
- Check
- Credit Card
Convenience Fee
Price: $0.00
Total
$0.00
THIS PAYMENT IS FOR THE BUTLER NYC TRIP PROTECTION PAYMENT. If this is not what you wanted, exit out and go to the right page.
When you click Submit, a payment page will display. YOUR ORDER IS NOT COMPLETE until you pay for the candy.