Campus Day Camp

2901 Campus Rd. Brooklyn, N.Y. 11210 (718) 421-7575

Credit Card Payment Authorization Form

Sign and complete this form to authorize Campus ASP Inc. to make charges to your credit card listed below.

By signing this form you give us permission to charge your account for the amount indicated.


Please complete the information below:
Campus Day Camp Credit Card Authorization
I
authorize Campus ASP Inc. to automatically charge my credit card
account indicated below for
$
and to keep this account on file for future charges.
Billing Address *
Billing Address
City
State/Province
Zip/Postal

Account Type *