Junior Lifeguard Program ATC Annual Fee Payment Page

Credit Card Payment with Stripe for Jrs Annual Fee

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Last Name

Last

Credit Card Details

Product

Quantity (see below)

Quantity Should be Equal to the # of Junior Lifeguard Participants in Your WASH Program.

Total

Authorization of Payment

I and/or my Organization hereby authorize(s) World Academy of Safety & Health (WASH) charge my credit card and/or debit card and confirm that the information for the credit card and billing address is complete and accurate. I have been informed that I waive my right to dispute the charges and/or initiate a chargeback assuming the amount charged matches the amount listed above. If I and/or my Organization is on thirty (30) Days Net Terms, I and/or my Organization further agree to submit payment, in full, within thirty (30) days of the date of this submission. A 3.5% or the maximum amount permitted by law (whichever is greater) per month late fee will be added to my and/or my organization’s account if balance is not paid in full within thirty (30) days.

Agreement

I agree to the World Academy of Safety & Health (WASH) Privacy Policy & Terms and Conditions

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