Credit Card Payment Form

**Please download, fill out, sign, and return the above form if paying by credit card**

You may send it through e-mail Hope@bootcampcodepink.com or snail mail.

6 week camp 120$ ( this is only available payment plan for walker location only)
1 year contract 65$
6 month pass $390
Month to month no contract $85

If you are mailing your payment, please mail to:

HOPE NEGROTTO

38156 HIDDEN POINT

GEISMAR LA 70734

**Please note that NSF checks are subject to a $35 NSF fee

2 lb Protein Shake Flavor ordering Choose Flavor Vanilla Strawberry Chocolate

5 lb Protein Shake Flavor ordering Choose Flavor Vanilla Strawberry Chocolate

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