WestiePass Contract

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

WestiePass Contract

First Name *

Last Name *

Email *

Phone Number *

I agree that the WestiePass is valid for one calendar month. WestiePass will be valid from the first day of the month to the final day of the month and includes all WCS group classes and WCS social dances. *

Yes

I would like my first month of the WestiePass to begin on the 1st of *

I agree to have my credit card on file charged automatically on the 1st of each month to cover the fee for the WestiePass. *

Yes

I agree that once my credit card has been charged I will not be able to receive a refund for that charge. *

Yes

I agree to provide a written cancelation request by the 20th of the month to cancel my WestiePass membership and all future charges associated with that membership. *

Yes

I agree that I accept these same policies for all future charges related to the WestiePass. *

Yes

By typing your name below, you accept all of the above policies. *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Ballroom in Boston. Report Abuse

Forms