Make a Custom Payment – The Champlain Club / Goethe Community Trust

Use this form to make a payment of a custom amount. If you are making a normal facility rental payment, please use our standard payment form instead.

Name(Required)

First Last

Email(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Payment Amount(Required)

Note

If there is any explanation you'd like to add, do so here.

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name