Free Money Form

By filling out and submitting this form you are authorizing Sparkling Pools to charge the attached credit card for your 2010 Pool/Spa Season.

Any amount you pre pay we will credit your account an additional 10%!

Name First Last
Email
Please charge my card the following amount:
I hereby authorize Harbor Hot Tubs, Inc. to apply the charges described below: Yes No
Type of Card MC Visa Amex
Account #
Exp. Date:
CVV2#:
Name on the Card
Billing Address on the Card
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
I understand and agree to the Terms and Conditions in this Agreement: Yes No
Please Initial Here
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