Complete the following form to arrange for monthly payments to be withdrawn from your credit card.

Today's Date
  
Member Name
Email Address
Name on Card
Card Number
Expiration Date
  
Billing Address
Billing Zip Code

I hereby authorize Alvin Golf & Country Club to debit the above credit card for the total amount due on my membership statement each month. Charges will include my membership dues (including cart barn and locker fees, if any) and any charges made in the Pro Shop or Grill on my membership account. I can receive a detailed printed or emailed copy of my statement at any time.

This agreement will continue until written or electronic notification is received by the club from the cardholder or member. Notification should be directed to Karen Farrell on the Contact Us page or to AGCC, PO Box 981, Alvin, TX 77512.

Signature
 
   

 

Farrell Documentation & Website Design

 


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Credit Card Charge Agreement