Artemis22 Beauty Club Membership Agreement
Name: DOB: Street Address: City:
State: Zip: Email:
Membership Details
Initiation Fee: $200
Monthly Fee: $100
Annual Maintenance Fee: $150
Paid Today: $
Remainder of membership paid in 11 monthly installments on or after the _______ day of each month.
Membership will auto-renew at the end of annual term paid on or after the _____ of each month until submission of a written termination request.
Membership Start Date: / /
Date of first automatic payment on or after: / /
I,________________ , authorize Artemis22 Beauty Club to charge my monthly membership fees to my financial institution via Electronic Funds Transfer service, with the credit/debit information that I have provided. I understand that I am in full control of my payment, and if at any time I decide to make any changes to my credit/debit card information, I must submit to Artemis22 Beauty Club the new banking information before the next due date.
If at any time I decide to terminate my membership, I am required to give Artemis22 Beauty Club a written notice 30 days before my next scheduled payment.
I also understand no refunds will be issued after membership due has been charged. Change of payment method will not affect other provisions and terms of my agreement.
Member Signature:
Date: / /
Signature of Parent or Guardian:
Date: / /
Witness Signature:
Date: ______/ /
Notice to Members
Do not sign this agreement before you have read it in its entirety. The member is entitled to a completed copy of this agreement. The member acknowledges that this document is an agreement and will become legally binding upon its acceptance by Artemis22 Beauty Club. The member also understands there will be no refunds issued for any charged [member] dues. The undersigned member acknowledges receipt of Artemis22 Beauty Club membership terms and conditions and has read, understands, and agrees to be bound by the terms and conditions as part of this agreement. Any member, who is under the age of 18, must have a parent or legal guardian co-sign and be present during all office visits. The co-signer, along with the member, agrees to be bound by all terms and conditions of this agreement.
Release and Waiver of Liability
I have read and understand this waiver and have been fully informed of all of Artemis22 Beauty Club terms and conditions as well as membership benefits and limitations. I certify that I have disclosed all medicated conditions that might affect my treatments. I understand that Artemis22 Beauty Club providers cannot diagnose any medical conditions and release them from any injury resulting from undiagnosed medical conditions present during my treatment. I assume all responsibility for updating changes in physical and mental condition and for reporting all injuries sustained at Artemis22 Beauty Club at the time of service.
Disclaimer
Artemis22 Beauty Club is not responsible for any injury or loss of property to any person while on the premises or participating in Artemis22 Beauty Club services. As a member, I assume full responsibility for services received at Artemis22 Beauty Club and shall indemnify Artemis22 Beauty Club, its affiliates, agents, and employees against any and all liability arising from services rendered.
Monthly Membership Dues
Membership dues will be automatically charged to member’s bank account/credit card on the ______ day of every month.
Card Information Card Number:
Cardholder Name:
Expiration:
Card Type: MC/ VISA/ AMEX/ DISCOVER
CVV2 Code/CSC # (if any):
Billing House Number:
Billing Zip:
Member Signature:
Date: / /
Signature of Parent or Guardian:
Date: / /
Witness Signature:
Date: / /
Artemis22 Beauty Club Membership Terms and Conditions
Monthly memberships are non-transferable and may not be shared.
Monthly membership payments or if paid in full is non-refundable.
Artemis22 Beauty Club reserves the right to change clinic policies, regulations, and pricing at any time upon providing reasonable notice.
Termination
A 30 day written notice before your next scheduled payment is required to cancel a monthly membership plan. No refunds will be issued after monthly membership due has been charged or paid in full. Remaining funds in the Client Bank must be used within 12 months of termination date.
Auto-Renewal
Your membership will automatically be renewed at the end of the annual term, unless you submitted a written request to terminate your membership.
An annual maintenance fee will be charged at the beginning of the new annual term, unless you submitted a written request to terminate your membership. During the renewal of your membership, your account will continually be charged the monthly membership fee. If your membership has been paid in full, Artemis22 Beauty Club will contact you regarding a renewal.
I understand and fully abide by the above terms and conditions by Artemis22 Beauty Club .
Member Signature:
Date: / /
Signature of Parent or Guardian:
Date: / /
Witness Signature:
Date: / /
Artemis22 Beauty Club Membership
- $200 initiation fee, non-refundable
- $100 monthly, applied to client’s wallet and may be used towards services including neuromodulators, dermal fillers, IM injections & sclerotherapy. Fees in the client’s wallet may not be applied to products.
- $150 yearly maintenance fee
10% Off Injectables
10% Off Products
*Pre-authorization for monthly credit or debit card is required.
