MONROE COUNTY BLACK CARD (MCBC)
Mailing Address where the Card should be shipped
Address Number and Street
Address 2 (Optional)
City
State/Province
Zip/Postal
Country
I Agree that I will pay the monthly fee of $12 to the Monroe County Black Card Program from now until I cancel my subscription by emailing mlozano@invictusathletes.org requesting the cancellation of my subscription and mailing the current MCBC Card to 1368 Five Points RIchmond Road, Bangor PA 18013. I also understand that MCBC Management can only assist me when a participating business does not honor their promotion that was stated in the monthly newsletter for the month in question. Please sign below if you agree to these terms.