Customer Agreement and Authorization Form
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Order#
I agree that this purchase is 100% legit and I am the owner of the card being used to make this purchase
*
I agree that Dark Label Hair is not responsible for any lost, damaged, or stolen goods during mail transit
*
Continue
Continue
Should be Empty: