I, the above-named authorized credit card user, give Tampa Bay Hypnotherapy and its representative express authorization to charge my credit card for the purposes detailed above. I understand that this form constitutes a legally binding contract and that by affixing my signature to this form, I will be held responsible for all agreed upon (as stated above) charges as well as any and all collection and legal fees. This credit card is authorized for only the charges noted above. By signing this "Credit Card Authorization" form, I/my organization acknowledge receipt and understanding of its contents, including its "Explicit Authorization" clause.