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I would like to make a     of   $ 30.00


  1. By clicking this box, I authorize Adventure Theatre MTC to charge the credit card I provided in the amount selected above.  I further authorize regular charges to my credit card in the same amount on the last Friday of each month. A receipt for each payment will be provided to me and the charge will appear on my credit card statement. I agree that no prior-notification will be provided unless the date or amount changes, in which case I will receive notice from ATMTC at least 10 days prior to the payment being collected. I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify Kathryn Vicere at 837-D Rockville Pike, Rockville, MD. 20852 in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next transaction date. I acknowledge that the origination of Credit Card transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this Credit Card and will not dispute these scheduled transactions; so long as the transactions correspond to the terms indicated in this authorization form.