Credit Card Authorization
This form will authorize Edwards Performance Horses to apply any outstanding balance owed to my credit card. This may include breeding fees, purchasing a horse and/or fees associated with training, showing or selling my horse. I understand that any charges are made on an "as incurred" basis.
I understand that if any charges exceed the maximum amount I have authorized, I will be informed in advance and reauthorize the additional charges.
I understand that if there is any dispute or dissatisfaction regarding the services paid herein, that said dispute will be taken up directly with Edwards Performance Horses and that any claim with the credit card company resulting in a "charge back" to Edwards Performance Horses shall constitute a Breach of Agreement or Breach of Contract as witnessed by my signature herein.
Amount of Authorization $_______________ one time occurrence or $____________ per month
Visa or MasterCard (circle one)
Card number: ________________________________ Expiration date: ______________
Card holder name: __________________________________ address:__________________________________ __________________________________ Phone # ____________________
email _________________________________________ Signature:_____________________________________ date: _______________
Please print this form and when completed, email to breeding@JaksArtifacts.com or mail to 27229 Bruella Rd., Galt, CA 95632