ACH Authorization Form
I understand that this is an electronic transaction, and these funds may be withdrawn from my account as soon as today. If I have opted for a payment plan, funds will be withdrawn on the first of the month. In the case of the payment being rejected for Non-Sufficient Funds (NSF), I agree to an additional $25.00 charge for each attempt returned NSF, which will be initiated as a separate transaction from the authorized payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I will not dispute Adventure Rabbi billing with my bank so long as the transaction corresponds to the terms indicated in this agreement.
If you prefer to pay by credit card, please fill out the credit card fields. Leave this blank if you prefer ACH.
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