AUTO PAY Form Sign Our Auto Pay Form for Hassle-Free Billing at GymStars AUTO PAY Consent Form Student Name:* First Last Parents Name:*Phone:*I hereby authorize GymStars, LLC to charge the following credit card amounts that I may incur for tuition, registration and pro shop items. I understand that GymStars, LLC will keep this information private and confidential. This agreement is valid until cancelled by me, the card owner. AUTO PAY needs to be cancelled in writing 2 weeks prior to the next billing cycle. PAYMENTS WILL BE DRAWN ONE WEEK BEFORE THE 1st DAY OF SESSION All fields are required!Address* Street Address City State / Province / Region ZIP / Postal Code Email* Signature*Date* Date Format: MM slash DD slash YYYY GymStars, LLC 210 Weiss Ave. St. Louis, MO 63125 GymStars-stl.com (314) 845-6600 This iframe contains the logic required to handle Ajax powered Gravity Forms.