Your Billing Contact Information

Pay by Card or Bank Account

 

First name*:

 

Last name*:

 

Phone*:

 

Email address*:

 

Billing address*:

 

Address line 2:

 

City*:

 

State*:

 

Zip code*:

  
 
 

PAYMENT OPTION ONE

Pay Via Credit Card:

 

Card type*:

 

Card number*:

 

Expiration date*(mmyy):

 

CVV2 Code*:

(last 3 digits of the number located on the back of your Discover, MasterCard, or Visa OR 4 digit number printed above your American Express Card account number on the front of your card)

 

PAYMENT OPTION TWO

Pay Via Banking Account:

 

Bank name*:

 

Bank routing number*:

 

Account number*:

 

 

  
 
 

The Fitness Profit Center

You are enrolling in our FPC membership program. You will have access to all the tools provided including your own website and blog combo for as long as you’re an active member.

Your account will be billed $249 today for the initial Setup and creation of your account. Automatic billing will then continue AFTER 1 month at $39 per month until you decide to cancel your membership.

You authorize a regularly scheduled charge of the agreed upon amount from Fitness 4 San Diego for your website & membership program. A receipt for each payment will be emailed to you and the charge will appear on your credit card statement.  You agree that no prior-notification will be provided unless the date or amount changes, in which case you will receive notice from us prior to the payment being collected.

You understand that this authorization will remain in effect until you cancel it by notifying Fitness 4 San Diego, and you agree to notify Fitness 4 San Diego of any changes regarding your account and provide information or termination of this authorization prior to the next billing date. You certify that you are an authorized user of this credit card and that you will not dispute the payments with our credit card company; provided the transactions correspond to the terms indicated in this authorization form.

IMPORTANT NOTICE: Cancellation of your account will result in the termination of all web sites, blog content, design elements, software and tools created by The Fitness Profit Center as these elements are the sole property of The Fitness Profit Center.

You can contact Fitness 4 San Diego at: (619) 709-1886 or omar@fitness4sandiego.com