Club Membership Registration Form

The Gloss Club Membership Application

Apply for unlimited annual beauty treatments from £999.99
Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Membership Type*

Unlimited Aesthetic Treatments - Excludes Injectables (£999)Unlimited Treatments, Full Access – Includes Botox, Fillers & Skin Boosters (£1999)
Social Media Handle (Instagram)
Where did you hear about us?*

A Friend or colleaugeGoogleBlog PostEmail MarketingFlyer/LeafletOther
Referral Code
Preferred way to contact*

PhoneEmailAny
Privacy Policy
Please reach out and read our Privacy Policy in order to understand how your information is used and shared, and check below if you accept the policy.
Type a question*

I have read, understood, and accepted the PRIVACY POLICY for membership.
At The Gloss, your privacy is important to us. We collect, use, disclose, and safeguard your personal information when you visit our clinic or use our website and / or services.

For more details, please reach out and read our Privacy Policy in order to carefully understand your rights and our obligations and check below if you accept the policy.
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The Gloss Club Membership Application