Credit Card Authorization Form

First Name

Last Name

Talent's Name

Email

Phone

Billing Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

Zip Code

By completing this form, I am approving the Green Room Acting Studio to set up a Paytrace account for the talent listed on this form and to charge appropriately for the services listed below.

Monthly Acting Classes: I understand that I can cancel the monthly on-going acting classes at any time by notifying the Green Room Acting Studio, in writing, ten (10) days prior to the first of the month.

Credit Card Number

Credit Card Expiration Date

Security Code

Signature

I am authorizing my credit card to be charged for the items above.

Thank you for contacting us!

Thank you for completing the credit card authorization form.

The final step is to sign the studio policies and procedures form. To make it easy, we are including a link:

https://www.greenroomactingstudio.com/form/policies-procedures

Please know that we hold a seat for you in the primary class in which you are registered. If you cannot make a class, please text us to let us know, so we can advise the instructor. We understand that life happens... most studios do not allow talent to make up a class. At the Green Room, we allow you to make up one (1) class in a month as long as you notify us in advance.

If you have any other questions, please do not hesitate to contact us.

Thanks,

Diane Marie
561-840-5030

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