I authorize the above named business to charge the credit card(s) indicated in this authorization form according to the terms outlined above. I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify the business in writing of any changes in my account information or termination of this authorization at least 30 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. This payment authorization is for the type of bill indicated above. I certify that I am an authorized user of this credit card(s) and that I will not dispute the payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form.
$299 Enrollment $149 Monthly
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CANCELLATION TERMINIATION
You are solely responsible for properly canceling your account. An e-mail or phone request to cancel your account is NOT CONSIDERED CANCELATION. You can cancel your account at any time by clicking on the link: https://billing.stripe.com/p/login/cN29DD9RmbTO3ja288
I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business. If spouse/significant other are enrolling please complete a separate form.
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