Merchandise Order Form -- Fax to (512) 462-4558
Name: __________
Mailing Address: __________
City, State ZIP: __________
E-Mail Address: __________
Phone Number: (_____)__________

Ordering Information
A $3.95 Shipping & handling charge will be added to each order. Texas sales tax of 8.25% will be charged on all orders.
Item Size Color Price Quantity Total
Birthday T-shirt Child 10-12 / 14-16
Adult S / M / L / XL
White only $8.50 ________ ________
"You're Zapped" T-shirt Child 10-12 / 14-16
Adult S / M / L / XL
Lime / Violet $11.50 ________ ________
"Don't Worry Be Zappy" T-shirt Child 10-12 / 14-16
Adult S / M / L / XL
Lime / Violet / Yellow $11.50 ________ ________
"You're Zapped" Baseball T-shirt Adult S / M / L / XL Grey with Black sleeves only $16.95 ________ ________
"Don't Worry Be Zappy" Baseball T-shirt Adult S / M / L / XL Grey with Black sleeves only $16.95 ________ ________
Hats Medium / Large Red / Black / Bucket $16.95 _______ _______
BlazerBucks Gift Cards $10 / $25 / $50 _______ _______
SubTotal _______
Tax (8.25%) _______
S&H $3.95
TOTAL _______

Credit Card Information for Fax Orders
Name on Card:__________
Card Type:__________ Expiration Date:__________
Card Number:__________
Signature__________