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ORDER DATE
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MM slash DD slash YYYY
IS THIS ORDER FOR A NEW OR RETURNING CUSTOMER:
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New
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CUSTOMER NUMBER
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NAME OF ORGANIZATION
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Who is being billed for this order?
ORGANIZATION TYPE
(Required)
Please choose the correct category.
ELEMENTARY SCHOOL
MIDDLE SCHOOL
HIGH SCHOOL
COLLEGIATE
PROFESSIONAL
CLUB/PRIVATE TEAM
ENTIRE SCHOOL DISTRICT
OTHER
OTHER ORGANIZATION TYPE
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SPORT/USE
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Please choose the correct category.
FLAG FOOTBALL
YOUTH LEAGUE
7on7 FOOTBALL
LINEMAN TRAINING
FULL CONTACT FOOTBALL
SOCCER
WRESTLING
RUGBY
MMA
WATER SPORTS
BASKETBALL
BASEBALL
CHEERLEADING
FIELD HOCKEY
LACROSSE
WATER POLO
VOLLEYBALL
OTHER
OTHER SPORT/USE
(Required)
Enter Sport/Use Here
BILLING AND SHIPPING INFO
BILLING CONTACT: NAME
(Required)
First Name
Last Name
BILLING CONTACT: EMAIL
(Required)
Enter Email
Confirm Email
BILLING CONTACT: PHONE
(Required)
BILLING ADDRESS
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
IS THE SHIPPING ADDRESS THE SAME AS THE BILLING ADDRESS?
(Required)
YES
NO
ADDITIONAL SHIPPING INFO
Recipient Name (optional)
First
Last
SHIPPING ADDRESS
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
RECIPIENTS PHONE NUMBER (OPTIONAL)
BILLING TERMS
BILLING TERMS
(Required)
Only institutions such as NFL, College, High School, Middle School or Elementary School accounts qualify for NET Terms. ALL OTHERS must provide valid credit card at the time of purchase, unless otherwise approved by management.
CREDIT CARD (2.99% Transaction Fee)
NET 10
NET 30
CUSTOMER PO#
If the customer has provided a PO with their order please include their PO#.
CUSTOMER PO DOCUMENTS (UPLOAD LINK)
Please upload PO Documents as provided by the customer.
Drop files here or
Select files
Max. file size: 50 MB.
CC INFO
NAME ON CARD
(Required)
CC NUMBER
(Required)
EXP DATE
(Required)
CVV
(Required)
This field is hidden when viewing the form
Section Break
TAX EXEMPTION NUMBER
For an order to qualify as Tax Exempt customers must provide Tax Exemption Number at the time of purchase. Tax is charged to customers in CA & TX.
CLIENT CONTACT INFO
IS THE CLIENT'S CONTACT INFO THE SAME AS THE BILLING CONTACT?
YES
NO
CLIENT CONTACT: NAME
(Required)
First
Last
CLIENT CONTACT: EMAIL ADDRESS
(Required)
Please enter the main contact's email address. This is where all order acknowledgements, tracking information and invoices will be sent.
CLIENT CONTACT: PHONE NUMBER
(Required)
IS THE PROOFING CONTACT INFO THE SAME AS THE CLIENT CONTACT CONTACT INFO?
YES
NO
PROOF APPROVAL: EMAIL ADDRESS
(Required)
PRODUCTS, QUANTITIES & PRICING
(What are you ordering, how many do you need and what are you charging the customer)
DELIVERY DEADLINE
(Required)
In-hand date, not the event date.
MM slash DD slash YYYY
THIS ORDER INCLUDES:
(Required)
GameBreaker Products
Uniforms
Facemasks and Gaiters
GAMEBREAKER PRODUCTS
GameBreaker Products
Select the Product Category and appropriate SKU from the drop downs and fill in the quantity and pricing info for each line item.
GameBreaker Products
SKU
Quantity
Price ($)
Add
Remove
Total ($)
UNIFORMS & APPAREL
Select the Product Category and appropriate SKU from the drop downs and fill in the quantity and pricing info for each line item.
Select the Product Category and appropriate SKU from the drop downs and fill in the quantity and pricing info for each line item.
Uniforms
SKU
Quantity
Price ($)
Add
Remove
Total ($)
UPLOAD UNIFORM EXCEL FORM
Upload the complete excel order form with the production files included and all unused pages cleared.
Drop files here or
Select files
Accepted file types: xlsx, xlsm, xlsb, xltx, xls, Max. file size: 50 MB.
FACEMASKS & GAITERS
Select the Manufacturer and Product from the drop down and fill in the type, quantity, and pricing info for each line item.
Select the Manufacturer and Product from the drop down and fill in the type, quantity, and pricing info for each line item.
Facemasks and Gaiters
Type
Quantity
Price ($)
Add
Remove
Total ($)
GRAND TOTAL
Grand Total
TAX & SHIPPING NOT INCLUDED
ART INFO
DOES THIS ORDER INCLUDE CUSTOM ART
(Required)
No, these are blanks
Yes, I need to attach art
File
Drop files here or
Select files
Max. file size: 24 MB, Max. files: 20.
IMPRINT INSTRUCTIONS
SALES REP INFORMATION
SALES REP NAME
(Required)
Please select your name from the list below.
Your Name
Alan Stender - 38
Alonzo Adams - 194
Brett Temple - 90
Chris Barnes - 217
Chad M. DeGrenier - 51
Craig Reddinger - 111
Don Martinez - 115
Evan Yabu - 88
House Account - 98
Jake Juels - 155
James Lott - 174
Jaxon McClure - 423
JD Roussel - 824
Jim Vader - 178
Joe Rodriguez - 144
Joni David-O'Connor - 274
Kyle Eversgerd - 128
Kyle Peterson - 422
Michael Juels - 1
Nick Juels - 168
Rich Tuason - 191
Joni David-O'Connor - 247
SALES REP EMAIL
(Required)
Please select your email address.
Your email address
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
ADDITIONAL INFORMATION/SPECIAL REQUESTS
CAPTCHA
ACCURACY CHECK
(Required)
I HAVE DOUBLE-CHECKED ALL THE INFORMATION IN MY ORDER FOR ACCURACY.