Summit Climbing Co.
Membership Office

Auto-Pay Authorization

Set up automatic recurring payments for your Summit membership. Fill this in once and your dues run on schedule — cancel any time.

Member
Devon Marsh
(555) 442-8810
Summit Annual — All-Access
Payment method on file
Credit / debit card Bank account (ACH)
Visa
3318
•••• •••• •••• •••• Entered securely at the front desk or online — never written here
Amount & schedule
$59.00
Month
July 1, 2026
I cancel
Authorization

RECURRING PAYMENT AUTHORIZATION

I authorize Summit Climbing Co. to automatically charge the payment method on file for the recurring amount and frequency shown above, beginning on the first charge date and continuing until I cancel. I certify I am authorized to use this payment method.

I understand I can cancel auto-pay at any time by contacting the membership office at least 3 days before the next charge, and that cancelling does not refund charges already processed or waive dues already owed.

I have read and agree to this recurring payment authorization.
Devon Marsh
Member signature
June 17, 2026
Date

Summit Climbing Co. · Membership Office · Manage or cancel auto-pay any time at the front desk.