D4U Sprint 6 Pack

1

I UNDERSTAND I AM ENTERING INTO A PAYMENT AGREEMENT FOR THE PURCHASE OF A DONE4U 6 PACK ON AN INSTALLMENT PLAN. I SHALL PAY ALL OF MY PAYMENTS ON TIME, AND UNDERSTAND THAT I CANNOT REFUND BASED ON THE INFORMATION PROVIDED IN THE PRODUCT.* This field is required.

YESNO

2

I UNDERSTAND THAT I AM RESPONSIBLE FOR COMPLETING MY PAYMENTS TO THE END OF ITS TERM, REGARDLESS OF WHETHER OR NOT I HAVE REDEEMED ANY/ALL OF MY SITES.* This field is required.

YESNO

3

I APPROVE AND AUTHORIZE _Averi LLC__ TO CHARGE MY CARD ON FILE FOR ALL PAYMENTS DISCUSSED IN THIS PAYMENT AGREEMENT AND ANY OTHER CHARGES I AGREE TO, FOR ALL FUTURE PRODUCT PURCHASES CONNECTED TO THIS, UNLESS STATED OTHERWISE AT THE TIME OF NEW PURCHASE.* This field is required.

YESNO

4

"I agree to the following terms and authorize my card to be charged now, and for all future payments."* This field is required.

YESNO

5

Name* This field is required.

First Name

Last Name

6

Email* This field is required.

example@example.com

7

Phone Number* This field is required.

Area Code

Phone Number