ACH Payment Signup Form "*" indicates required fields Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Checking Account Number*Checking Account Number Confirm*Routing Number*Routing Number Confirm*Account Type*CheckingSavingsConsumerBusinessConsent* I authorize Wind Dance Farm, Inc.I authorize Wind Dance Farm, Inc. to electronically debit my bank account according to the terms outlined below. I acknowledge that electronic debits against my account must comply with United States law. Signature*CAPTCHA