Escape Massage Membership Agreement

3 months ($165 prepaid) 6 months ($55 monthly) 12 months ($55 monthly)
3 months NON-RECURRING ($190 prepaid)  
  1. Clients may choose a membership with commitment periods of (3) months prepaid - $165 recuring or $190 non-recurring or (6) months at $55 monthly recurring or (12) months at $55 monthly recurring with an additional 1 hour free gift certificate. Each month of membership includes a complimentary 1hr Massage (conducted at Escape Massage offices only).
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  2. Members’ Dues are paid thru automatic withdrawal (recurring billing) with a valid current credit card or checking account. Note: A $10 fee will be applied for each credit card denial. A fee of $35 will be applied for each failed checking account withdrawal or charge back. It is up to the member to maintain account balances and current credit card information.
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  3. All memberships will continue as recurring from month to month after commitment ending date at $55 monthly except Three-month non-recurring members. Members may cancel their membership after the first recurring bill date following the commitment ending date with 30-days written notice. Upon expiration or cancellation, unused complimentary massages are lost and have no cash value.
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  4. Twelve-month memberships must be in effect for at least six months, after which, a fee of $75 will be charged for early cancellation. Three-Month & Six-Month memberships may not be cancelled. Cancellation request must be in writing or you may use the bottom of this form. Return all requests to Escape Massage. (Fees and/or prices subject to change after commitment end date.)
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  5. Membership is valid only for member listed and cannot be transferred or used by anyone other than member.
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  6. Monthly membership fees must be current and paid in full to receive complimentary massages.
  7. Management has the right to terminate this agreement at any time.

Membership Benefits:

* Each monthly membership fee entitles the member to one complimentary one-hour massage. Prepaid members may use Complimentary massages any time during membership. Unused free massages transfer each month of membership. The hour massage cannot be split but can be lengthened to 90 minutes for an additional fee of $20. Rates for massages, guest and gift certificates for this agreement, are as follows:

30 minutes · $27
45 minutes · $36
60 minutes · $45
90 minutes · $63 

* Members may purchase unlimited massages for themselves but their guests and gift certificates are limited to two (2) for any one person within the last six (6) month period.
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* 8 hours notice required for cancellations or member will forfeit free massage.
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Date: _______________ Commitment ending date: _______________ Recurring bill start date:_______________

LAST name: (Print)_______________________________________ FIRST name: _________________________

Address: ___________________________________________________________________________________

City: ______________________________________ State : _______ Zip: ________________________________

Home phone: ____________________ Work phone: _____________________ Cell: _______________________

Member Number : ______________ E-mail Address: ________________________________________________

Credit Card Number: (Visa) (Mastercard) (Amex) ____________________________________________________

Exp. Date: _________/_________ Digit Code (3 or 4 digits on back or front)________________________________  

Name of Bank: ______________________________________ Copy of voided check # ______________ attached

Routing #: ___________________________________ Account #: _____________________________________

By my signature below, I agree with the terms of this agreement.

Date: ______________________ Signed: _________________________________________________________

Membership Plus:

Date: ___________________ for add-on: _________________________________________________________

The plus feature is added to the original Escape Massage membership agreement for a period of not less than three (3) months. The plus feature allows primary member to share membership privileges with one other member who is living in the same household. This add-on will increase the cost of monthly membership by $10. Member privileges transfer between the primary and the add-on member only. Only the primary or the add-on member may use the one free monthly massage. During the membership term, both member and add-on may purchase unlimited massages for themselves, and they may purchase massages for their guest and gift certificates at membership pricing. Member guest and gift certificates are limited to no more than two (2) occurrences for any person in a six (6) month period per primary membership.

Please terminate membership # ___________ Signed:__________________________ Date:______________

Mail completed form to:
Escape Massage, Inc. Attn: Memberships
3430 Pump Road Richmond, VA 23233

OR
Fax completed form to:
(804) 360-2799