Authorization for Automatic Payment

Authorization for Automatic Payment

I authorize the YMCA of Rapid City to initiate monthly charges, on or about the 5th of each month, to my bank account or credit card institution, for payment of my YMCA membership and/or program fees due under the Monthly EFT Plan. I authorize my financial institution to honor these charges to my account. The YMCA of Rapid City will notify me in advance via first class mail whenever my membership and/or program fees change. I authorize the YMCA of Rapid City to continue monthly charges based on the changed membership and/or program fees.

This authorization is to remain in effect until revoked by me in writing. Until the YMCA receives and has had a reasonable time to act on such notice, the YMCA shall be fully protected in honoring any charge by the YMCA of Rapid City against my account named on the front. I agree to notify the YMCA, in writing, of any changes and/or cancellations by the end of the month, to take effect the following month. I understand that there are no refunds on membership dues.