MEMBERSHIP FORM

MEMBER INFORMATION:

* If member is under 18, please indicate parent name as well

MEMBERSHIP TERM:

* One month notice is required for cancellations on any term of contract.  Discuss rate options prior to submitting form.

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BILLING INFORMATION:

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AUTHORIZATION

I authorize
Satori Wellness Studio to initiate debit entries to my account as indicated above for the specified term.  I agree as a member not to rely on any statement, oral or written, except contained herein this membership agreement.  I understand this agreement cannot be cancelled without penalty and no refunds will be issued for amounts paid for the duration of the contract term.  After this time, I understand billing will continue and membership will be renewed for a new period equivalent to this initial contract unless otherwise re-signed.  I understand that I may cancel at any time after this initial contract by sending a written notice to Satori Wellness Studio one month in advance, prior to the end of contract.  If a member, at any time during the term of the agreement wishes to cancel the contract, there will be a cancellation fee charged, as noted, above (see: membership term).


WAIVER AND INDEMNITY AGREEMENT

Permitting, and in consideration of, the above-mentioned person to join and/or renew membership with Satori Wellness Studio and participate in any/all studio activities available at or through Satori Wellness Studio. Such member hereby assumes all risks of such activities and voluntary releases and discharges, and waives and relinquishes any and all claims or causes of action for personal injury, property damage, or wrongful death occurred to him/herself arising as a result of engaging or receiving instruction in studio activities or any activities incidental thereto for the period signed. Said activity or instruction may begin or continue for him/herself and he/she hereby agrees that under no circumstances will he/she or his/her heirs, executors, administrator assign, or prosecutor present any claim or personal injury, property damage, or wrongful death against the studio or any of it's officers, agents, employees or volunteers. It is the intention of the members of this instrument to exempt and relieve Satori Wellness Studio from any liability.


PARENTS OR LEGAL GUARDIANS

As parent or legal guardian of before-mentioned member, for and in consideration of, my child/youth participation in Satori Wellness Studio activities offered, state that I/we have read the above waiver, and release and indemnify.  I/we expressly agree that the terms and conditions of this waiver shall apply to and shall be bond upon me/us.  


ACKNOWLEDGEMENT

I agree and acknowledge the foregoing paragraphs and am aware of the potential risks and dangers incidental to engaging in Satori Wellness Studio activities and am fully aware of the legal binding that is set through the submittal of this form.