Saint Ignatius Swimming Pool
Herbst Natatorium
2001 - 37th Avenue
San Francisco, CA 94116-1165
Visa/MasterCard membership payments

St. Ignatius College Prep can bill your Visa or Mastercard account monthly to pay your swimming dues. With this form, we ask if you would like to begin or continue use of this method for monthly payments. We would charge your credit card on the 3rd of each month, or the first business day after a weekend or holiday after this date.

If you wish to use this credit card service, return the below authorization to the Aquatic Office. Please notify us regarding any changes in credit card numbers, expiration dates, etc. You may phone the Aquatic Director for further information at (415-731-2522).


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Name (please print) ___________________________________________

Program (circle one) Masters $45 per month Hammerhead $40 per month

Type of card (circle one) Visa Mastercard

The card number is: _______________/______________________/______________

Expiration Date: _____/_____
mo. yr.

I authorize St. Ignatius College Prep. to charge my Visa or Mastercard as here indicated, according to the below beginning and ending months I select. I understand that this arrangement may be canceled at any time by contacting St. Ignatius College Prep.

BeginningMonth/Year: ___________/________ Ending Month / Year: _______/_______

Name: _______________________________________________________

Address: _____________________________________________________

City: _______________________________________________________

Home Phone: _________________________ Work Phone: _____________________


Signed: ___________________________________________ Date: _______________