If you would like to enjoy the convenience of automatic recurring billing, simply complete the Bank Draft or Credit Card Information section below and sign the form. All requested information is required. Upon approval, we will automatically bill your bank account or credit card for the amount indicated and your total charges will appear on your monthly statement. You may cancel this automatic billing authorization by sending written notice in such time (no less than two weeks prior to your next scheduled payment date) and in such manner to allow both First Coast Taekwondo and the receiving financial institution a reasonable opportunity to act on it.
Please note this form is SSL secure. In addition, the Auto Bank Draft & Auto Credit Card Payment Information field is an encrypted field.
You may cancel this automatic billing authorization by sending written notice in such time (no less than two weeks prior to your next scheduled payment date) and in such manner to allow both First Coast Taekwondo and the receiving financial institution a reasonable opportunity to act on it.
Recurring Automatic Payment Authorization Terms:
This payment authorization is to remain in full force and effect until I, the account/card holder, notify First Coast Taekwondo of its cancellation by sending written notice in such time and in such manner to allow both First Coast Taekwondo and the receiving financial institution a reasonable opportunity to act on it. Accountholder by execution of this agreement waives any right to receive advance notice of the deduction associated with the services provided by First Coast Taekwondo or Agent and further authorizes a service charge not to exceed $35 for returned, unpaid or declined transactions from the Bank and other fees and charges to be paid under this agreement. Accountholder further warrants that he/she is the owner or authorized signer of the referenced account and has full authority to enter into this agreement.