I ________ (place name below) hereby authorize THE HEALTHY KITCHEN MIAMI to charge my credit card above for the total cost of the Keto-X program amounting in $796 plus any additional and agreed upon applicable charges such as taxes, delivery and add-ons. I understand that my information will be saved to file for future transactions on my account. I am aware that due to the content specific layout of this program restrictions are not allowed but taken into consideration. **I am also aware this is a 28 day program which I am not able to opt out from. *