Schedule Appointment with Massage Elite

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First Name *

Last Name *

Phone *

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
Three Sessions Per Month	x $390.00	$390.00 per month
Total: $390.00	Coupon:

Cancellation Policy
To avoid penalty: Cancel at 24 hours or more in advance.
Expect a penalty if: You cancel less than 24 hours in advance.
Penalty: (Option 1) Same Day Cancellation fee of $50.
(Option 2) If inside a package, forfeit one appointment
*You may choose either of these options

We look forward to working with you!