Membership Sign-Up Form

Interested in a Membership? Save 15% on regular massages to keep you feeling your best!

Complete the form below to get signed up for your Gold or Platinum Membership!

Name

First Name

Last Name

Email

Phone

(###)

###

####

Which membership are you interested in?

Length of Session

Preferred Start Date

we suggest the beginning of the month

MM

DD

YYYY

Platinum Members: Preferred Date

Select preferred date for second membership pay date. We suggest around the 15th of each month

MM

DD

YYYY

Select Secure Payment Option

Using a current card on file?

Please enter the last 4 digits of the card on file to verify

Secure Payment Verification

Digital Signature

Please enter your First and Last name to complete order per your secure payment selection

Have more questions? Call us at 801-503-0848 ext 2