Precision Gymnastics and Tumbling auto draft form

Precision Gymnastics and Tumbling Auto Draft Submittal Online

I give permission for Precision Gymnastics and Tumbling to draft funds every month from my account information listed below, in the amount of submitted below. I understand that funds will be debited on the 1st of each month. I further understand that I am required to give two week notice to change or discontinue this auto draft.

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Auto Draft Form

Fax to (972)907-2248

* Required fields
Name *
E-mail Address *
Amount I authorize to debit from my account monthly: *
Students' Name(s): *
Cardholder Name: *
Card Type: *
Card Number (no spaces or dashes): *
Expiry Month: *
Expiry Year: *
3 digit security code (on back side of card): *
Street Address *
City *
Zip Code *