Comfort Club - Payment Subscription Full Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Type of Payment Plan*AnnualMonthlyNumber of Systems*One - $179/yrTwo - $324/yrThree - $469/yrFour - $614/yrEnhanced Plan: One - $247/yrEnhanced Plan: Two - $460/yrEnhanced Plan: Three - $673/yrEnhanced Plan: Four - $886/yrNumber of Systems*One - $15.50/moTwo - $28/moThree - $40.50/moFour - $52/moEnhanced Plan: One - $21.50/moEnhanced Plan: Two - $39/moEnhanced Plan: Three - $56.50/moEnhanced Plan: Four - $75.50/moIf you have more than 4 systems, please call us at (210) 987-5587.Total $0.00 * I authorize regularly scheduled charges to my credit card or bank account. I understand that I will be charged the amount indicated for each agreed upon billing period. A receipt for each payment will be provided to you after each transaction. To cancel a charge, you may notify our office at least 10 days prior. Enter Name below As Agreement to the Above.* Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name
