Sizing Kit

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Credit Card Authorization Form

This is to be completed by the Cardholder

Cardholder Name

Order Type

Authorization to charge for the sizing kit: $75 . This will be credited to the order once the order is placed and the sizing kit is returned. If the Sizing kit is not returned you will acquire additional fee of $150. You will be charged for the shipping to and from you the client. Please return the sizing kit with in 2 weeks weeks from the date you received the kit. Unless other arrangements are made. If not returned to us in the time frame You will forfeit your deposit.

Sizing Date

Card Holder Billing Address:





Home Number

Cell Number

Card Number

Exp. Date

Security Code Number

This is the 3 digit code on the back of your card for Mastercard, Discover, Visa with American Express it is the number on the front of the card

Type of card
VisaMasterCardDiscoverAmerican Express

Card Holders Signature

Todays Date