Example of Membership Contract for Pre-Paid Massages:
( ) 3 months ($150 prepaid in FULL) $150.00 paid in full
(3 Pre-Paid Cards supplied and all must be used on or before expiration date of :____/____/______) _____(Initial)
Optional: Please add the total gratuity for these 3 massages to my bill: $__________ (tip)
( ) 6 months ($288 Prepaid in FULL) $288.00 paid in full
Bonus 15% discount card given and expires on ____/_____/______
6 Pre-Paid Cards supplied and all must be used on or before expiration date of :_____/____/______) _____(Initial)
Optional: Please add the total gratuity for these 3 massages to my bill: $__________(tip)
This membership is non-transferable unless I specify one spouse or partner at the time of my membership: Name____________________________________________________
Phone Number (____) _______________________________ DOB______/______/_______.
I understand he/she will have to use the pre-paid card for their visit. ( ____)Initial
Cancellation of an appointment must be received 24 hours prior to my appointment. Less than 12 hours notice of cancellation and no-shows will forfeit their pre-paid appointment. _______(Initial)
OR
Example of Membership contract for Monthly billing Massage Contract:
( ) 3 months (Monthly Billing at $50/month)
Optional: Please add monthly gratuity of $________ to each monthly billing
( ) 6 months (Monthly billing at $48/month) (Bonus 15% discount card which can be used on all other services)
Optional: Please add monthly gratuity of $________ to each monthly billing
I understand and agree with the following terms and conditions of this membership:
The membership monthly fee is specified above. As long as I am enrolled in this monthly billing membership, this fee will be charged automatically to my credit card on the first day of each month. As long as my membership is paid in full I will be considered a member in good standing. _______(Initial)
I am required to be a member in good standing for a period of no less than 3/ 6 consecutive calendar months from the day my membership takes effect. _______(Initial)
Monthly billing membership entitles me for one prepaid massage (Relaxation or Deep Tissue) per month for the
duration chosen above. When contracting for 6 months, all other services listed in the menu will be available at a discount of 15% on regular price. _______(Initial)
Membership billing massages do not accrue from month to month ______(Init). As long as I am a member in good standing I may schedule one prepaid massage per month.
This membership is non-transferable unless I specify one spouse or partner at the time of my membership: Name______________________________ Phone Number (____) __________________ DOB______/______/_______.
I understand he/she will have to use the pre-paid card for their visit. ( ____)Initial
There is NO refunds given at any time for any reason. I understand I have to provide a 15-day notice of cancellation prior to the first of the month in which I wish my membership to be discontinued. I understand that in order to successfully cancel this automatic charge, my 15-day notice of cancellation to Origins of Wellness must be in writing. (via fax: (414) 235-9704 or personal letter). I further understand that I have to return my pre-paid cards to Origins of Wellness in order for me to successfully cancel my membership. The early termination fee for cancelling before my contract is up is $50. ________(Initial)
Cancellation of an appointment must be received 24 hours prior to my appointment. Less than 12 hours notice of cancellation and no-shows will forfeit their pre-paid appointment. _______(Initial)
