Thank you for selecting Basketball Solutions for your internet presence! 

Below you will find our authorization form that you will need to print out and fax/mail back to us no later than 5 business days after your hosting account has been activated. This form gives Basketball Solutions/Internet Services authorization to bill your credit card for your hosting, and/or domain registration fees. All charges will appear on your credit card statement under the name "Internet Services-WDBG".

This form MUST be completed in order for your account to remain on our servers or for us to register your domain name. Domain registrations will not be completed without this authorization form. If this form is not returned during this period, your account will be disabled until this information is received. You may return the authorization by one of the followings methods:

Fax: (413) 425-8918
Fax: (800) 861-0956

Email: accounting@basketballsolutions.com

Regular Mail:

Internet Services
C/O Basketball Solutions
P.O. Box 237
Woodbridge, VA 22194

If you intend to return the form by standard mail please e-mail us to let us know so that you will not experience any downtime.

Please complete all sections, if something does not apply indicate N/A.

Domain Name: _________________________________

Hosting Plan: _________________________________

One-time billing charge for domain name registration fees: _________________________________

Web hosting billing charge: _________________________________

Monthly

Quarterly

Yearly

(circle one)

Cardholder Name: _________________________________
Cardholder Billing Address: _________________________________

City State Zip Code: _________________________________

Country: _________________________________
Credit Card Number: _________________________________
Expiration Date: __________

Credit Card Type (circle one):

Visa

Master Card

American Express

Discover

Cardholder Telephone Number: ________________________________
E-mail address for billing issues: ________________________________

To authorize billing to the above credit card, please sign and date below:

X_____________________________________________(Cardholder Signature)
X_____________________________________________(Date)

My signature states that I authorize Basketball Solutions/Internet Services to charge web hosting fees to my credit card as specified above. These charges will occur monthly until I cancel my account. I also understand that the amount stated above may differ if I add or remove features to my account, and that I will agree to any new charges before I am billed. I understand that I have the option to use a different form of payment as long as I notify Basketball Solutions/Internet Services within 24 hours of my billing renewal date, and complete a new authorization form. This authorization is valid until revoked in writing.

**All cancellations must be received 5 days prior to the end of your billing cycle. Acceptable forms of cancellations are regular mail, fax, or e-mail. Phone requests will not constitute acceptance of any cancellation.

**Credit card fraud will not be tolerated. We actively and aggressively fight all forms of credit card fraud.