• Pay Statement

    Aloha Foot Centers
  • prevnext( X )
    USD

    Credit Card


  • Recurring Payment Credit Card Authorization Form
    Schedule your payment to be automatically charged to your Credit Card.

    Here’s How Recurring Payments Work:

    You authorize regularly scheduled charges to your credit card. You will be charged the amount indicated below each billing period. A receipt for each payment will be sent to you. You agree that no prior-notification will be provided unless the date or amount changes.  

    You may cancel this authorization at any time by contacting us.  This authorization will remain in effect until cancelled.

     

  • Clear
  •  -

  • Should be Empty: