Card Authorization Form

Wikiup Tennis & Swim Club – Credit Card Update Form

Use this form to update the credit card on file or to add a new credit card to your account.

Name(Required)

Name on card

First Last

Email(Required)

Membership Type(Required)

Tennis & Swim (Full membership)

Swim Membership only

Other

I authorize Wikiup Tennis and Swim Club to initiate MONTHLY deductions from my account below, for my monthly dues and any charges for goods and/or services during the month.

I authorize Wikiup Tennis and Swim Club to initiate WEEKLY deductions from my account below for any goods and/or services charged during the week.

Once a month beginning the first (1st) day of:(Required)

Payment Type(Required)

Credit Card

Debit Card

Card Number(Required)

Expiration Date(Required)

Security Code (V-Code)(Required)

Zip code(Required)

Consent & E-Signature

By entering your full name and the date of completion of this form, you agree that this will serve as an electronic signature (E-Signature).

Name (E-Signature)(Required)

First Last

Date (E-Signature)(Required)