Freedom Pass Registration

Your membership will begin on the date we receive your completed registration.

First Name (required)

Last Name (required)

Preferred Name (required)

Address (required)

City (required)

State (required)

Zip (required)

Phone (required)

Email (required)

Who Referred You (required)

Credit Card Information

Credit Card (required)

Exp. Date (required)

CVV (required)

Name On Card (required)

Billing Address (if different from above)

Address

City

State

Zip

Amount: $195 for the first month + $40 per month for the next 11 months, or paid-in-full at start for $635. (Founding Members: $49 per month for 12 months.)

EFT Authorization: I authorize WorldLegacy to initiate charges for my dues and purchases to the credit card indicated above. I understand I will be charged each month on or after the day of the month my membership begins. This authorization is to remain effective until WorldLegacy has collected for all charges assessed in connection with the terms and conditions of this agreement. For paid-in-fill customers, the tuition is fully non-refundable after the cancellation period of three (3) days.

One Year Membership: Member has applied for a one-year membership. In consideration thereof and notwithstanding any of the other terms and conditions of this agreement, Member shall be liable for dues and services for the full one year term of this agreement in the amount stated above.

Cancellation & Refund Policy: All Members are entitled to terminate the agreement via a written notice of cancellation received by WorldLegacy within three (3) days of making this agreement; all initial fees and dues will then be refunded.

Collection of Fees: Members are liable for any collections fees, reasonable attorneys fees, court costs and all other expenses incurred by WorldLegacy in collection an over due account. Any member whose account remains unpaid thirty (30) days after the date charged may, at the discretion of WorldLegacy, have their membership privileges terminated.

Membership Transfer: Member may not transfer his or her membership to anyone else.

I accept all of the terms and conditions set forth in this agreement.

I Agree


Event Venue Date
NC165 Leadership Millennium Hotel June 23, 2017 7:00 pm   Closed
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