KMR Enterprises, Inc.
ABSOLUTE TAN
APPLICATION FOR EFT TANNING MEMBERSHIP
Name__________________________________
Client # ________________
MONTHLY PAYMENT PLAN AUTHORIZATION
I request that my monthly dues be charged directly to my bank per my:
_____ Visa _____ MasterCard _____ Discover _____ American Express
COLLECTION INFORMATION
CC Account # ______________________________
EFT Start Date _______________________
Credit Card Expiration Date ________________
Monthly Amount ______________________
TERMS OF MEMBERSHIP
Upon acceptance of this application, the undersigned shall receive membership rights and privileges, and agrees to abide by all rules and policies of KMR Enterprises, Inc., which are subject to change and which, in the opinion of the owner of KMR Enterprises, Inc., are deemed necessary and reasonable for the best interest of its members. KMR Enterprises, Inc. may be closed during certain legal holidays, and use of the membership is also subject to interruption for needed repairs and maintenance. I understand that the initiation fee is a onetime only charge and must be included with my first month dues. If I discontinue my membership and wish to rejoin, I will be subject to the initiation fee at that time. The initial payment of membership fees and monthly dues are not refundable unless canceled in writing within three days of purchase. Should I decide to cancel with the three days, any fees for tanning used will be deducted from my refund. I hereby release KMR Enterprises, Inc., and its owners and employees from any and all liability for any damage or injury, which I may receive while utilizing the equipment and facilities, and assume all risk for claims arising from the use of said equipment and facilities.
INFORMATION ON ELECTRONIC FUNDS TRANSFER (EFT)
Memberships are billed automatically to your Visa, MasterCard, Discover or American Express Credit Card for the convenience of both our members and ourselves. The procedure is quite simple. A deposit, which covers the initiation fee and first month dues, is collected upon joining. The following monthly dues will be automatically withdrawn from your chosen account. For your understanding, please read the following information:
*The EFT is a continuous membership plan. I understand that this membership will stay in effect indefinitely unless I choose to end it in writing with my signature and date.
*It is my complete understanding that to cancel my membership and to stop the EFT, I must submit, in writing, my request to cancel my EFT.
*It is my understanding that if I decide not to tan during any month that I may freeze my account for $5 per month by filling out the appropriate form.
*It is my understanding that any and all changes, freezes and/or cancellations must be written on the appropriate membership change form and be received by KMR Enterprises, Inc., no later than close of business on the last day of the month prior to the month to be changed. (Ex. All changes for October must be received by close of business on September 30th).
*Should any membership draft not be honored by my credit card company for any reason, I realize that I am still responsible for the payment. In addition, a service charge of $10 may be charged to my account. This is in addition to any service charge that my bank may charge.
*I understand that should I choose to cancel my membership, then decide to rejoin, that I will be responsible for paying the current membership fee again at that time.
I have read and understand the EFT bank draft plan and the terms of membership. By signing below I agree to abide by the terms of this agreement.
_________________________________
Member Signature
_______________
Date
_____________________________
Employee Signature