HWS & Whiplash Group

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(Gold) Year ONE membership with CERTIFICATION single payment

One-time payment for the first year and the LEVEL 1 certification course. Includes all seminars that year.

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Recurring Payment	$2500.00 Annually auto-debits starting 02/05/2026

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I authorize HWS & Whiplash Group to debit the account listed hereon $2500.00, & agree to perform the issuer obligations. I authorize HWS & Whiplash Group to auto-debit the account listed hereon $2500.00 Annually starting 02/05/2026 & 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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