Body Mechanik Massage Wellness Membership Form

Full Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Emergency contact

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Start Date

Date

Welcome

Thank you for becoming a Body Mechanik Massage Wellness Member! Our membership program is designed to help you maintain your health and wellness through regular massage therapy. We appreciate your trust and look forward to being part of your wellness journey.

Membership Includes:

$99 per month

• One massage session each month

Includes: Add- on per request

(one add- on )

• HOT STONES

• RED LIGHT THERAPY

• CUPPING

• HEATED BAMBOO

• Member discounts on additional services

• Priority scheduling

• Exclusive member promotions

Membership Terms

• Monthly payments are automatically charged on the day your membership starts

• Membership continues until canceled.

• A 30-day written notice is required to cancel.

• Missed appointments without proper notice may result in forfeiture of that session.

• Sessions must be used according to membership policy.

I authorize Body Mechanik Massage Wellness to charge my payment method monthly for my membership.

Member Benefits:

As a Body Mechanik Massage Wellness Member, you receive:

• Discounted monthly massage

• Savings on additional massage sessions

• Exclusive wellness promotions

• Priority appointment scheduling

• Personalized treatment planning

Thank you for choosing Body Mechanik Massage Wellness. We look forward to helping you feel your best every month!

Membership Plan $99 per month plus discounts on other services

Health History Questionnaire. Massage Therapy Informed ConsentI understand that massage therapy is intended for relaxation, stress reduction, and relief of muscular tension. I understand massage therapy is not a substitute for medical care, diagnosis, or treatment.

Cancellation & Rescheduling Policy
• Please provide at least 24 hours' notice to cancel or reschedule.
• No-shows and late cancellations may result in forfeiture of your monthly session.
• Arriving late may shorten your session to avoid delaying other clients.

I agree to inform my therapist of any health changes before each session.

I authorize Body Mechanik Massage Wellness to charge my payment method monthly for my membership.

Please verify that you are human

Body Mechanik Massage Wellness Membership Form

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