Credit Card Authorization

By filling out the form below, I am authorizing the one-time use of my credit card information to be used exclusively for production expenses related to the project stated as: Sam’s Club Project Epic, an event taking place between (October 15-October 19).

Luminous U.S. Productions, LLC hereby confirms the information provided will be used one-time only for the project stated above and a receipt will be provided immediately upon use for client’s records.

Please complete the form below

Name

First Name

Last Name

Email Address (for receipt)

Credit Card Number

Expiration date (MM/YYYY)

3-digit code

Street Address:

City

Zip Code

Message (optional)