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I hereby authorize DEEP SOUTH STEEL dba RENT BUY BOX  to charge my credit card (provided below) for agreed upon purchases and transactions. I understand that my information will be saved to file for future transactions on my account. I understand that I may cancel this authorization in the future by contacting DEEP SOUTH STEEL dba RENT BUY BOX directly. 

First Buyer Name
First Name*
Middle Name
Last Name*
Phone*
First Buyer Date of Birth*
Date of Birth
First Buyer Signature*
Second Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Third Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Fourth Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Fifth Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Sixth Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Seventh Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Eighth Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Ninth Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Tenth Buyer Name
First Name*
Middle Name
Last Name*
Buyer Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Credit Card or ACH Information

3% Fee for Credit Card & 1% Fee for ACH

Card Type:*
Visa
Mastercard
Discover
American Express
Card Holder Name: *
Card Number: *
Expiration Date: (Format Example - 01/22) *
CCV : (small 3 to 4 digit number on card) *
Address Line #1 *
Address line #2
City *
State *
Zip Code *
Routing Number
ACH - Bank Account Number
Account Type
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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