*PLEASE PRINT THIS PAGE BEFORE SUBMITTING TO KEEP A COPY FOR YOUR RECORDS.

I authorize regularly scheduled charges to the bank account or credit card provided to Meridee Winters School of Music over the phone or online and I understand that I will be automatically charged on the first of each month based on the chosen lesson length and current tuition rates (see the school's website or contact the office for current tuition rates).

I agree that if I choose to pay by credit card, I will pay an additional 3% processing fee.

I agree that no prior-notification of the scheduled charges will be provided unless the date of payment or amount of payment changes, in which case I will receive notice prior to the payment being collected.

I agree that in the event that there is a change in tuition rates, I will be notified in advance and prior to payment being collected.

I understand that if I change my lesson length or if a new student is added in my household, the school will adjust my recurring monthly payment to the appropriate tuition rates.

I agree that the school may adjust my monthly payment to reflect a tuition credit (decrease) or to cover the cost of shows/materials (increase), in which case I will receive notice prior to the payment being collected.

I understand that this authorization will remain in effect until I cancel by phone or email, and I agree to notify Meridee Winters School of Music by phone or email of any changes in my account information or termination of this authorization at least 10 days prior to the next billing date.

If the first of the month falls on a weekend or holiday, I understand that the payments may be executed on the next business day.

For ACH debits to my bank account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates.

In the case of an ACH transaction being rejected for Non Sufficient Funds (NSF) or failure to process a credit card transaction, I understand that Meridee Winters School of Music may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25.00 charge per incomplete transaction, which will be initiated as a separate transaction from the authorized recurring payment.

I certify that I am an authorized user of the credit card/bank account provided and will not dispute these scheduled transactions with my bank or credit card company so long as the transactions correspond to the terms indicated in this agreement.

By signing this, I also agree to the Meridee Winters School of Music policy, including the cancellation policy, available anytime at www.meridee-winters-school-of-music.com. I understand that I will always receive notice of any policy changes.

Do you Agree to the Terms of the Agreement Above? *

Yes

No

Date: *

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