Nfinity Athletic Credit Card Authorization Form

Date * +

Organization and Athlete Names *

Total Amount *

Email Address *

Contact Phone Number *

Card Information

Visa

Name on Card *

Credit Card Type *

Credit Card #: *

Expiration Date (mm/yy) *

CVV Code *

Billing Zip Code *

Billing Address

Type *

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

I hereby authorize Nfinity Athletic LLC to charge the above listed credit card for the products I have purchased.

Authorized Cardholder Signature *

clear

Please contact me with any questions. Thank you for your business!!

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Jodi Matthews | Southern California Sales Representative

E: jodi@nfinity.com P: (951) 760-8035

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