Credit Card Information

First name

Last name

Credit Card Number

Expiration Date

Billing Zipcode

Security number on back of card

I give permission for Joel to run my credit card on the 1st of each month for the marimba classes.
I agree

I agree to give Joel notice on the 15th of the month if I will not be continuing the following month. Failure to give proper notice may result in me being charged.
I agree

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