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Please fill out details below:

I hereby grant Reinvent U Boot Camps (DBA:Reinvent U Spa & Wellness) to withdraw the funds based on my payment option chosen above via automatic credit/debit for the RESET 6 week weight loss program. The transaction on your bank statement will constitute receipts for payment on your account. The privilege of making payments under this arrangement may be revoked by the company if any item is not paid upon presentation. If this auto debit option is revoked by the company for any reason, it does not release you from your financial obligation. A service fee of $50 will be assessed and drafted from your credit/debit card on file for insufficient funds. In the event the client becomes past due and is referred to an outside collections agency or attorney by RIU, client will be responsible for the cost of collection services at the rate of 20% of the balance due, along with reasonable attorney fees and court cost incurred by RIU. Client payments are non-transferable and non-refundable. Company does not provide client with credit or a monetary reimbursement if you choose or can’t participate in the RESET 6 week weight loss program.

By signing below you are certifying that you are at least 19 years old and that you have reviewed and agree to the Terms and Conditions of this agreement. You further understand that you are responsible for payment described herein. Acknowledged and Agreed.

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