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DocuSign Envelope ID:6D7ED599-91 FF-43AF-9C2F-3897F7360AC8 <br /> Credit Card Authorization <br /> I hereby certify that I am an authorized representative of Member/Client,that I am an authorized signor on <br /> the credit card listed below,that I have the authority to authorize charges to the credit card,and that the address <br /> below is the billing address for the credit card. By signing below,I irrevocably authorize all charges for deposits <br /> as they become due,payments as they become due,and outstanding amounts and/or charges owed to the Club as of <br /> the date of the Event or upon cancellation of the Event to be charged to the following credit card: <br /> ❑Master Card ❑Visa ❑American Express <br /> Credit Card Number: Expiration Date: <br /> Cardholder Name: <br /> Billing Address: <br /> Phone: <br /> Authorized Signature: Date: <br /> Initial: <br /> 6112 <br />