Form

HOLIDAY DISCOUNT ORDER FORM

Treat yourself....or...someone special this holiday season!
YOUR NAME: *

First Name Last Name
YOUR EMAIL: *
YOUR PHONE NUMBER: *

- Area Code Phone Number
RECIPIENT'S NAME: *

First Name Last Name
RECIPIENTS' EMAIL *
SPECIAL MESSAGE TO RECIPIENT:
(optional)
HOW TO DELIVER GIFT CERTIFICATE: *

Email this gift certificate to recipient on the date specifiied below. Email this gift certificate to me Mail to me Mail to recipient
ENTER DATE YOU WANT GIFT CERTIFICATE SENT VIA EMAIL:

YOUR ADDRESS

RECIPIENT'S MAILING ADDRESS:

All sales are final. No refunds!!
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However, you can share or transfer your sessions to a friend.

** Offer expires Jan 1st, 2016 **
CHOOSE YOUR PACKAGE or FLAT RATE (prices do not include tax)

6 1hr Sessions [reg $450] $ 405.00 CAD

12 1hr Sessions [reg $840] $ 756.00 CAD

24 1hr Sessions [reg $1,560] $ 1,404.00 CAD

12 x Group Sessions [reg $270] $ 243.00 CAD

24 x Group Sessions [ $480] $ 432.00 CAD

5 x 1/2 hr Sessions [reg $200] $ 180.00 CAD

10 x 1/2 hr Sessions [reg $400] $ 360.00 CAD

FLATE RATE $ 25.00 CAD

FLATE RATE $ 50.00 CAD

FLATE RATE $ 75.00 CAD

FLATE RATE $ 100.00 CAD

FLATE RATE $ 200.00 CAD

Subtotal $ 0.00 CAD Tax $ 0.00 CAD Total $ 0.00 CAD
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HOLIDAY DISCOUNT ORDER FORM