top of page

CREDIT CARD AUTHORIZATION

​

Credit Card Authorization

Please complete all fields. You can cancel this authorization at any time by removing the saved card. This authorization will remain in effect until canceled.

​​​

​

​

​

​

​

​

 

 

 

 

I authorize Kelley Gray, LLC to directly charge my credit card above for any future session charges on my account. I understand that I can cancel this authorization at any time.​

Card Type
INTAKE FORM
bottom of page