Escape Massage Membership Agreement

Please provide us with all information requested below.
When completed, click "Submit Memebership Agreement" button and your information will be sent to Escape Massage.
A representative will be in contact with you soon to obtain your payment information.

Select Membership Type:

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).
    Initial
  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.
    Initial
  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.
    Initial
  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.)
    Initial
  5. Membership is valid only for member listed and cannot be transferred or used by anyone other than member.
    Initial
  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.
Billing Start date:
Commitment End date:
 
LAST Name:
FIRST Name:
Address:
City:
 State:
 
Zip:
Home Ph:
Work Ph:
Cell Ph:
E-mail:
Escape Massage will contact me to obtain payment information.
* SPAM CHECK:
Please tye the number 711 in the field.

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. Initial

* 8 hours notice required for cancellations or member will forfeit free massage. Initial

Membership Plus:

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.

Name of add-on member:

Please terminate membership #: Date:

Signature (Your typed full name in this box will serve as your signature)

By submitting this electronic form, you agree and understand the terms of this agreement.
Management has the right to terminate this agreement at any time.