Billing Frequency *

Monthly Advance Auto-Pay (1st of month)Weekly (Friday for following week)Per Day at Standard RateOne-Time Charge

Payment Method *

ACH Bank Draft (preferred · no fee)Credit / Debit Card (3% fee)HSA / FSA CardCheck / Money Order (no auto-pay)

Acknowledgments *

I authorize Boca Raton ADCC to charge the account/card above on the schedule selected.I understand the $500 enrollment deposit and $75 registration fee are non-refundable.I understand all payments are non-refundable; eligible cancellations may be credited per policy.I agree to a $35 late fee after 5 days past due and $35 returned-payment fee.I have read the Payment Sheet, FAQ, and Center Policies & Procedures.

Payment Authorization Request

Authorize Payment