Charge Card Form Clause Samples

Charge Card Form. Completion of the Charge Card Consent form is mandatory. The charge card consent form is kept on file. If payment is not received by 5:30pm on Monday, your account will automatically be debited for the week of care due. You will be assessed a late fee of $5.00 per day, per child. A receipt will be issued. Upon withdrawal from the SAP, if all payments have been received, this form will be shredded.