My Spa My Way Membership Agreement

My Spa My Way

700 E. Kings Highway

Shreveport, Louisiana 71105

318-861-1886

Membership Agreement

Name*

DOB*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone*

Package Details (Check One)*

MonthlyAnnually

Monthly Fee

$159$79

Annual Fee

$1,908$948

Amount Paid Today*

Remainder of membership paid in 11 monthly installments on or after the Day of month day of each month.

Membership will auto-renew at the end of annual term for $ Fee /month paid on or after the Day of month of each month until submission of a written termination request.

Membership Start Date*

Date

Membership End Date*

Date

Date of first automatic payment on or after*

Date

I, First Name* Last Name*, authorize My Spa My Way to charge my monthly membership fees to my financial institution via Electronic Funds Transfer service, with the credit/debit information that I have provided.

I understand that I am in full control of my payment, and if at any time I decide to make any changes to my credit/debit card information, I must submit to My Spa My Way the new banking information before the next due date. If at any time I decide to terminate my membership, I am required to give My Spa My Way a written notice 30 days before my next scheduled payment. I also understand no refunds will be issued after membership due has been charged. Change of payment method will not affect other provisions and terms of my agreement.

Member Signature*

Date*

Date

Signature of Parent or Guardian

Date

Witness Signature

Date

Notice to Members

Do not sign this agreement before you have read it in its entirety. The member is entitled to a completed copy of this agreement. The member acknowledges that this document is an agreement and will become legally binding upon its acceptance by My Spa My Way. The member also understands there will be no refunds issued for any charged [member] dues.

The undersigned member acknowledges receipt of My Spa My Way's membership terms and conditions and has read, understands, and agrees to be bound by the terms and conditions as part of this agreement.

Any member, who is under the age of 18, must have a parent or legal guardian co-sign and be present during all office visits. The co-signer. along with the member, agrees to be bound by all terms and conditions of this agreement.

Release and Waiver of Liability

I have read and understand this waiver and have been fully informed of all of My Spa My Way membership terms and conditions as well as membership benefits and limitations. I certify thatI have disclosed all medicated conditions that might affect my treatments. I understand that My Spa My Woy's providers cannot diagnose any medical conditions and release them from any injury resulting from undiagnosed medical conditions present during my treatment. I assume all responsibility for updating changes in physical and mental condition and for reporting all injuries sustained at My Spa My Way at the time of service.

Disclaimer

My Spa My Way is not responsible for any injury or loss of property to any person while on the premises or participating in My Spa My Way's services. As a member, I assume full responsibility for services received at My Spa My Way and shall indemnify My Spa My Woy, its affiliates, agents. and employees against any and all liability arising from services rendered.

Monthly Membership Dues
Membership dues will be automatically charged to member's bank account/credit card on the Day of month* day of every month.

Card Number*

Expiration Date*

Card Type*

MasterCardVisaAMEXDISCOVER

Cardholder Name*

CVV2 Code/CSC #*

Billing Zip*

Billing Phone*

Please enter a valid phone number.

Signature of Parent or Guardian

Witness Signature

Date

Member Signature*

Date*

Date

Beauty Membership Terms and Conditions

Monthly memberships are non-transferable and may not be shared

Monthly membership payments or if paid in full is non-refundable

My Spa My Way reserves the right to change clinic policies, regulations. and pricing at any time upon providing reasonable notice

Freezing a Membership

There may be times when a member will need to freeze his/her membership for a short period of time, due to circumstantial reasons such as military leave, pregnancy. extended illness, relocation, etc. When a membership is frozen, the member is not authorized to use his/her membership services or benefits during the freeze period.

You must be a member for at least 30 days and have made at least one month's membership payment in order to be eligible to freeze your account. Memberships may be frozen once during your annual contract period, for a minimum of 30 days and a maximum of 3 months, depending on the circumstantial reason that will be determined by My Spa My Way. The member may designate a date to end their freeze period at any time, or on {date}. If no end date is given, the membership will be frozen for the full 3 month freezing period. At the end of the membership freeze term, your dues will continue with your next scheduled electronic funds transfer date. Your initial membership expiration date will be extended by the amount of time that your membership was frozen. The terms and conditions will continue to apply through the extended membership term. To initiatea freeze, submit a written request to My Spa My Way.

Termination

A 30 day written notice before your next scheduled payment is required to cancel a monthly membership plan. No refunds will be issued after monthly membership due has been charged or paid in full.

Auto-Renewal

Your membership will automatically be renewed at the end of the annual term, unless you submitted a written request to terminate your membership. During the renewal of your membership, your account will continually be charged the monthly membership fee. If your membership has been paid in full, My Spa My Way will contact you regarding a renewal.

I understand and fully abide by the above terms and conditions by My Spa My Way.

Witness Signature

Date

Member Signature*

Date*

Date

MySpa MyWay Membership - $49 One Time Activation Fee, then $159 or $79 monthly (with a 30-Day Cancellation Notice)

Choose One Service Per Month:

50 Minute Swedish Massage
European Facial
Gentleman’s Facial
Classic Manicure w/Spa Pedicure

Additional Member Amenities:

Unlimited Use of Sauna
$25 Birthday Certificate
10% off Additional Spa services and all retail spa products
Invitation to Special Member Events

*** The Membership Package is a 6 or 12-month commitment that begins on day of purchase. Pre- authorization for monthly credit card or debit is required

[One Guest per Visit accompanied by a member for Member Discount]