• Deep Roots Massage Membership Application

    Agreement & Security Deposit

  • Welcome!  Congratulations on making a commtiment to your own health and wellness.  

    The membership application is the first step in a two part process.  Once you have completed this one year agreement and paid the security deposit you're halfway there! 

    Next, you'll need to call us with your preferred card number for monthly billing in order to activate your membership. 

    Please call 603-352-0734 if you have any questions.

    See you soon!

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • Please choose your membership.*

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          60 Minute Monthly Massage Membership Security Deposit
          $84.00$84.00
            
          75 Minute Monthly Massage Membership Security Deposit
          $105.00$105.00
            
          90 Minute Monthly Massage Membership Security Deposit
          $126.00$126.00
            
          Total
          $0.00$0.00
          Credit Card
          Billing Address
        •  -
        • I would like my membership to begin:*

        • Pending completion of the member agreement, automated monthly billing of {pleaseChoose} will begin on my next appointment, occuring within the same calandar month as today's date {date} and will continue on the first day of each month following for a minimum of 12 months. 

          After 12 months of membership, membership auto renews on a month-to-month basis and you can use your UNUSED security deposit your last massage. Written notice is required to discontinue membership.  

          Member rates are 20% below standard rates. Should standard rates for massage increase member rates increase will increase accordingly.

        • Pending completion of the member agreement, automated monthly billing of {pleaseChoose} will begin on the first day of the first month following today's date {date} and will continue on the first day of each month following for a minimum of 12 months. 

          After 12 months of membership, membership auto renews on a month-to-month basis.  Written notice of at least 30 days is required to discontinue membership.  

          Member rates are 20% below standard rates. Should standard rates for massage increase member rates increase will increase accordingly.

        • I understand and agree to the following:*
        • Should be Empty: