Option 2 - Change Card on File

Player Name

First NameLast Name

Parent Name

First NameLast Name

Parent Date of Birth

MonthDayYear

Phone Number

Please enter a valid phone number.

Email

example@example.com

I authorize Express Baseball or its third-party agents on its behalf and the financial institution designated (or any other financial institution I may authorize at any time) to charge my designated credit card for regular recurring payments and any other one-time payments which may cause such payments to vary in amounts, for payments of all charges arising under my Express Baseball Club membership, including but not limited to current or any outstanding Membership Dues, Uniform or Practice Gear, any late fees, program fees, joining fees, administration fees, or other charges which arise from this membership, whether incurred by me or by others on my membership. Unless otherwise authorized by {parentName}, such charges will be debited on the 1st of the month. I may change my designated credit card by any means permitted by Express Baseball, including but not limited to in person at an Express Baseball facility, online, or by calling our office.

Signature

I authorize use of this card for future payments made to Express Baseball Club For:

Option 2 Monthly Draft

$399.39

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country