APPENDIX A – Pre-Authorized Debit (PAD) Agreement

Member Information

Member Number

Primary Member *

First

Last

Address *

Email *

Cell Phone *

The Kelowna Yacht Club, and the financial institution designated, upon receipt of this form, and required documents, will begin recurring payments either monthly or annually as authorized *

I wish to set up monthly installments for my dues and fees.
I wish to have my dues and fees withdrawn annually.

Monthly Installments: withdrawn on or around 15th and every month thereafter of the following amounts: *

Monthly, 1/12th of the annual membership dues, fees and, if applicable, moorage fees withdrawn on or about the 15th of every month.
Monthly, any house account balance owing from the previous month(s) withdrawn on or about the 15th of the current month.
Annually, the Prepaid Minimum Spend withdrawn in full on November 30th of each year.
If applicable, any initiation payment will be withdrawn in full on November 30th of each year.

Annual Option: Withdrawal of annual payments of: *

Annually, the full membership dues, fees and, if applicable, moorage fees on or about November 15th.
Monthly, any house account balance owing from the previous month(s) on or about the 15th of the current month.
Annually, the Prepaid Minimum Spend withdrawn in full on November 30th of each year.
If applicable, any initiation payment will be withdrawn in full on November 30th of each year.

Financial Institiution

For a direct debit of your bank account, the Kelowna Yacht Club will require official bank documentation indicating your account the funds will be pulled from. This can be either a Void Cheque or an Official Bank Document.

Please upload:

either a Void Cheque or an Official Bank Document from your financial institution:

File Upload *

Click or drag a file to this area to upload.

Please upload a Void Cheque or an Official Bank Document

Payments *

I authorize Kelowna Yacht Club and the financial institution designated to begin deductions of monthly regular recurring payments and/or one-time payments as authorized

Acknowledgements

Signatures – Acknowledgements *

I understand that a Late Payment Fee of $50.00 (plus applicable taxes) will be levied for rejected payments for any reason; inaccurate bank account information, NSF (non-sufficient funds); bank account closed, etc.
I am aware that two (2) dishonoured payments in a twelve (12) month period in will result in termination of the monthly agreement (if applicable), as per Club Policy. Any remaining fiscal year dues and fees will be billed and payable immediately. Further information regarding accounts in arrears can be found in the Account Payment and Billing Policy, Code of Conduct, and Regulations on the Kelowna Yacht Club website.
I understand that the Kelowna Yacht Club may not assign this authorization, whether directly or indirectly, by operation of law, change of control or otherwise, without providing at least 10 days prior written notice to me(us).
I agree that this PAD agreement will remain in effect until Kelowna Yacht Club receives written notification of its change or cancellation at least 10 business days before the next debit is scheduled. Notification may be via email or hardcopy delivery to addresses below.
I, have certain recourse rights if any debit does not comply with this agreement. I have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on my recourse rights, I may contact my financial institution or visit www.payments.ca

Signatures

Full Name: *

By typing out my full name below, I acknowledge that I have read, understand and agree to the terms and conditions stated in this electronic form. I further understand that this electronic form and will have the same legal effect as a written signature.

Office Notes

5-Day Forecast