Regenerative Collective Private Membership Association (PMA) Membership Application & Agreement

Private Membership Association (PMA) Membership Application & Agreement
Member Information
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Membership Terms
By signing below, I acknowledge and agree:
1. I am voluntarily joining the Regenerative Collective, a Private Membership Association ("PMA").
2. I understand this is a private, contractual agreement between myself and the Association, and not open to the general public.
3. Services provided may include aesthetics consulting, skincare education, wellness support, and related private services.
4. I understand these services are for members only, are not a substitute for licensed medical care, and I accept full responsibility for my choices as a member.
5. I release, waive, and hold harmless the Association, its trustees, officers, and representatives from any claims arising from my participation.
6. I agree to respect the confidentiality of Association activities and materials.
7. I understand membership may be terminated for non-payment, misconduct, or violation of this agreement.
Member Signature*

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Fees
Membership Fee: One time fee of $129.00
Service Fees: To be agreed upon prior to service.
Acknowledgment

By signing this application, I confirm that I have read, understood, and voluntarily agree to the terms of this Membership Agreement.
Member Name*

First NameLast Name
Member Signature*

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Date*

MonthDayYear
Date
Association Trustee/Representative

First NameLast Name
Association Trustee/Representative Signature

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Date

MonthDayYear
Date
Should be Empty:

Private Membership Association (PMA) Membership Application & Agreement

Member Information

Membership Terms

Fees

Acknowledgment