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Bowflex Barbie Fitness Card Authorization
Credit/Debit Card Authorization for Group Fitness Training
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Email
*
Your email
Please Complete the Fields Below- Your transcation receipt will be sent to your email once payment has been processed ( Please allow a few minutes after submitting your form)
Name On Card
Your answer
Card Number
Your answer
Expiration Date On the Card
Your answer
CVC
Your answer
Payment is for
Group Fitness $155.00
I authorize the payment of $155
YES
NO
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Todays Date
MM
/
DD
/
YYYY
Signature/Initial
Your answer
Cell Phone #
Your answer
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