HWS & Whiplash Group

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(Gold) Year ONE membership and CERTIFICATION

ONE year (first year) membership including the LEVEL ONE certification program with the Whiplash Group. We highly recommend LEVEL 2 or PITI's certification at a future date.

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Recurring Payment	$208.00 Monthly auto-debits starting 03/05/2025

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I authorize HWS & Whiplash Group to debit the account listed hereon $208.00, & agree to perform the issuer obligations. I authorize HWS & Whiplash Group to auto-debit the account listed hereon $208.00 Monthly starting 03/05/2025 & agree to perform the issuer obligations. I affirm that the information entered on this form is true and correct.

HWS & Whiplash Group
10464 S. Redwood Dr South Jordan, UT 84095
(385) 257-1700

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