Deep Roots Massage Membership Application

Deep Roots Massage Membership Application

Agreement & Security Deposit
Welcome! Congratulations on making a commtiment to your own health and wellness.

The membership application is the first step in a two part process. Once you have completed this one year agreement and paid the security deposit you're halfway there!

Next, you'll need to call us with your preferred card number for monthly billing in order to activate your membership.

Please call 603-352-0734 if you have any questions.

See you soon!
Dear Members,

To continue providing high-quality care while maintaining living wages and benefits for our talented team, we will be adjusting our rates by 5% starting January 2, 2027. Following your January 1st automated payment, you will see a $4 per hour increase for your sessions.

We are so grateful for your support and truly honored to help you feel your best. Please feel free to reach out to us directly if you have any questions.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

60 Minute Monthly Massage Membership Security Deposit

$84.00

75 Minute Monthly Massage Membership Security Deposit

$105.00

90 Minute Monthly Massage Membership Security Deposit

$126.00

Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Email
example@example.com - Please use the best email to reach you on the day of your massage.
Phone

Area CodePhone Number - Please choose the best number to reach you on the day of your massage.
I would like my membership to begin:
Pending completion of the member agreement, automated monthly billing of {pleaseChoose} will begin on my next appointment, occuring within the same calandar month as today's date {date} and will continue on the first day of each month following for a minimum of 12 months.

After 12 months of membership, membership auto renews on a month-to-month basis and you can use your UNUSED security deposit your last massage. Written notice is required to discontinue membership.

Member rates are 20% below standard rates. Should standard rates for massage increase member rates increase will increase accordingly.
Pending completion of the member agreement, automated monthly billing of {pleaseChoose} will begin on the first day of the first month following today's date {date} and will continue on the first day of each month following for a minimum of 12 months.

After 12 months of membership, membership auto renews on a month-to-month basis. Written notice of at least 30 days is required to discontinue membership.

Member rates are 20% below standard rates. Should standard rates for massage increase member rates increase will increase accordingly.
I understand and agree to the following:
Signature
Should be Empty: