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Secure Your Spot: Modeling Camps and Programs Payment Authorization Form

Fill out the payment authorization form to secure your child’s spot in our exciting Modeling Camps, Parties, and Programs! Please provide the necessary details, including student and class information, credit card details, and your authorization for charges. Your child's memorable experience starts with us, and completing this form ensures a smooth registration process. For assistance, contact us via email at registration@modelinga2z.com or call (301) 801-4556. Thank you for choosing Modeling A2Z!

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Secure Your Spot: Modeling Camps and Programs Payment Authorization Form

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  1. Z A 2 Modeling Camps-Parties-ProgramsforKids! TM Payment Authorization form Name of Student:_________________________________ Name of Class/Party or Program:__________________________________ Type of Credit Card:_______________________________ Visa, MasterCard, Discover, AM EX, Debit Name of Credit Card Holder:______________________________ Primary Phone Number:____________________________Email:_____________________________________________________ Address of Card Holder:_______________________________________________________________________________________ Credit Card Number:________________________________________ Expiration Date:_____________ Three or Four Digit Code:_________ I authorize Modeling A2Z make an initial charge to my credit card for the following amount $______________ I authorize Modeling A2Z make a balance charge to my credit card for the following amount $___________ on __________ Date Signature of Card Holder:________________________________________Date:______________ Email to: registration@modelinga2z.com or Fax to: 1-301-874-8657 2 Tel. (301) 801-4556 MODELING AZ, LLC * P.O. Box 150 * Adamstown, MD 21710 * * Fax (301) 874-8657 www.modelinga2z.com

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