By clicking submit, you are formally requesting to have Encore Ballroom Couture to return your dress(es) that are currently registered in our inventory. By pulling your dress prior to the original expiration date of your Registration Contract, there will be a penalty of $250, plus shipping costs. You understand that by pulling your dress, it will no longer appear on our website or be available to our clients for try-on, rental or purchase. You authorize full payment of any pull fees and shipping cost (if applicable) to be charged to the credit card you have provided on this contract, prior to shipment. You verify that you are of legal age (18 years or older) and legally authorized to use the credit card and/or FedEx account number provided in this form. In the future, if you would to re-register the dress you are requesting back, the $80 registration fee will apply. Thank you for entrusting our company with your dress and we look forward to working with you in the future!