Name* First Last Date* MM slash DD slash YYYY Please enter the amount you are authorizing Southern Curl to charge on your credit card. This amount will be sent to you in the form of a self-pay link and must be completed in order to secure your appointment at Southern Curl Type of CardAmexVisaDiscoverMastercardSignatureby signing this document, you understand your deposit can be returned only if you cancel before the 48 hour cancelation policy, otherwise you will forfit this deposit in full. Δ
