Payment Authorization Form

• We offer the convenience of charging your lessons, show bills and/or services provided to you by VISA, MasterCard or AMEX.
• There is a processing fee of 3.5% for this service.
• All lessons must be prepaid on the first of every month.
• All invoices will be billed and sent by email on the first of each month for your review. The invoice will be charged with your card on file on the seventh of each month, unless paid beforehand. If the invoice becomes past due (on the 8th or later) a $25 late fee will be applied. Past due invoices are subject to a 1.8% finance charge after 30 days.
• If there are any discrepancies, they must be brought to our attention within the 7-day period of the invoice date.
• To use this service, please complete and submit the form below.
• Your credit card authorization must be signed and on file before any charges can be made.

Cardholder Name (as it appears on card) *

Email *

Type of Card *VISAMASTERCARDAMEX

Card Number *

Expiration Date *

Security Code/CVV *

Billing Zip Code *

Payment Confirmation *

• I hereby authorize Four Gs Equestrian to charge my credit card for agreed upon lessons, show bills and or services provided. I understand my information will be saved on file for future transactions on my account..

Signature (Use your mouse, or finger/stylus on touch screens) *

Clear Signature

Date *

Submit