CFA PAYMENT PLAN – FLAG FOOTBALL SEASON

(Please circle location) OAKLEY SAN RAMON CONCORD

California Football Academy offers a payment plan for the program registration fee of our Flag Football program. This plan allows the total registration fee to be split into no more than 3 payments. There must be a form of payment on file to satisfy future payment agreement, either a credit card (recommended) or by check(s).

Payment 1: Due at the time of registration(Non- Refundable after last In-person registration date of current season).

Payment 2 and/or Payment 3: remainder of the fees are due as scheduled below. Each future payment will be two (2) weeks apart, with the entire fee paid no later than 6 weeks after the start of the current season.

(1/3 to be paid at time of registration, 2nd payment of 1/3 to be paid 2 weeks after, with remaining balance of 1/3 payable 2 weeks after the last payment)

Please make check or money order payable to: California Football Academy

Payment Plan Registration

Parent's Name: ______Phone#: ______

E-mail address: ______

Player’s Name(s)/ Division(s): ______

Total Fees Due: $ ______

Amount / Will pay by
(Date) / How Paid (Circle) / Check # / Amount Paid / Received by / Date Paid
1st Payment / $ / Due at registration / Cash
Check
Credit / $
2nd Payment / $ / Cash
Check
Credit / $
3rd Payment / $ / Cash
Check
Credit / $

By signing below, I am agreeing to the terms and conditions of this payment plan. I understand that payment plan fees are non-refundable. I am also fully aware that if my balance is not paid as per this agreement or other payment arrangements are made, my child may not be able to continue the season until payment is paid in full.

Parent's Signature: ______Date:______

California Driver License Number (or ID) : ______

Credit card on file with signed authorization ( ) Checks* on file ( ) check no.’s: ______, ______

*Checks will not be accepted if a previous check has been returned for NSF or Closed Account.

Rev 090717

California Football Academy

Oakley ∙ San Ramon ∙ Concord

925-625-2222

Credit Card Payment Authorization Form

Sign and complete this form to authorize California Football Academy / Diablo Football to make the following debit/charges listed belowto your credit or debit card.

By signing this form, you give us permission to debit/charge your account for the amounts indicated on or after the indicated date. This is permission for the transaction(s) listed below, and does not provide authorization for any additional unrelated debits or credits to your account.

Please complete the information below:

I ______authorizeCalifornia Football Academy / Diablo Football to charge

(full name)
my credit card account indicated below as scheduled:

$______on or after ______.

(amount) (date)

$______on or after ______.

(amount) (date)

$______on or after ______.

(amount) (date)

Payments are for ______.

(description of goods/services)

Billing Address______Phone#______

City, State, Zip ______Email______

Account Type: Visa MasterCard
Cardholder Name______
Account Number______
Expiration Date ______
CVV Code ______
Zip Code associated with card ______
(Please print legibly)

I authorize California Football Academy / Diablo Football to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for the transactions noted above. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.

SIGNATURE DATE