Reward Points Enrollment

Name

First

Last

Phone Number

Email

Birth Date

Address

City, State

ZIP Code

Products You're Interested In (Check all that apply)

Select Your Reward Points Tier

Premium Level – $40/Month – Reimbursement of $10 per week, Earn reward points on purchases, Early access to product drops, and Free shipping on orders. **Requires CC on file for monthly membership fee**

Credit/Debit Card Type

Cardholder Name

Credit/Debit Card Number

Exp. Date

Card Birth Card

CVV

Authorization Agreement

I authorize Soil Co to charge Credit or Debit Card for $40 per month. By submitting this form, you, the customer, give us, the merchant, permission to debit your account for the amount indicated on or after the date of submission.
I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify the merchant in writing of any changes in my account information or termination of this authorization at least 45 days prior to the next billing date. If the above payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. I acknowledge that the origination of card transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/debit card and will not dispute these scheduled transactions with my bank or credit card company, so long as the transactions correspond to the terms indicated in this authorization form.

Soil Co