Sage Nutrition | Credit Card Authorization Form
Completion of this form authorizes Sage Nutrition, LLC to charge your credit card for sessions at Sage Nutrition, LLC as well as authorize this card to be kept on file at Sage Nutrition, LLC. In addition, you authorize Sage Nutrition, LLC to charge your credit card $50 for cancellation of sessions not honoring the 24-hour cancellation policy as well as missed sessions and you guarantee payment for any services rendered made with your credit card, including renewed cards.
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Name on Card *
Card Number *
Expiration Date *
Security Code *
Billing Zip Code Associated with Credit Card *
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