Club Midwest Hour Membership Agreement

check one:
3 months ($180 prepaid)
3 months NON-RECURRING ($195 prepaid)
6 months ($60 monthly)
12 months ($55 monthly)


1. Clients may choose a membership with commitment periods of(3) months (prepaid), (6) months (recurring) or (12) months
(recurring).  12-month members receive a free one-hour gift certificate at sign-up.  3-month memberships are prepaid ($180 for
recurring or $195 for non-recurring). 6 and 12-month memberships are billed monthly. Each month of membership includes a
complimentary 1hr Massage & 15 Minute session in our FAR Infrared Sauna – (conducted at Massage Midwest offices only)

2. Members’ Dues are paid with a valid current credit card for automatic monthly withdrawal (recurring billing).Late fee:  If
Massage Midwest is unable to collect your monthly dues from this source for any reason within five days of due date, Massage
Midwest will assess a $15 late fee penalty. Note: A $10 fee will be applied for each credit card denial. It is up to the member to
keep credit card information updated.
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3. All memberships will continue as recurring from month to month after commitment ending date except Three-month non-
recurring members.  Members may cancel their membership after the first recurred billing 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.
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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. Return all
requests to Massage Midwest. (Fees and/or prices subject to change after commitment end date.)
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5. Membership is valid only for member listed and cannot be transferred or used by anyone other than member.
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6. Your current monthly membership fee must be paid in full to receive complimentary monthly massages.

7. Management has the right to terminate this agreement at any time.


Date:                                Commitment ending date:                                  Recurring billing date:                                

Last name:                                                             First name:                                                                                 

Address:                                                                                                                                                                  

City:                                                                             State                                     Zip:                                  

Home phone:                                           Work phone:                                                  Cell phone:                                

E-mail Address:                                                                                                                                                  

Credit Card Number: (Visa) (Mastercard) (Amex)                                                                                                           

Exp. Date:              /                          Digit Code (3 or 4 digits on back or front)                      



Membership Benefits:

Each monthly membership fee entitles the member to one complimentary one-hour massage / sauna session. Prepaid
members may use Complimentary massages any time during membership. Unused free massages transfer each month of
membership. The hour massage cannot be split.  Add-on rates for guest and gift certificates for this agreement, are as follows:

30 minutes (massage) - $30

60 minutes (massage / sauna) - $50

Ionic Detox Foot Bath - $25

Ear Candling - $20


* Members may purchase unlimited massages for themselves but their guests and gift certificates are limited to two(2)/ month.
.
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**24 hours notice required for cancellations or member will forfeit free massage.
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Membership Plus:

Date:                                        Person for add-on:                                                                                                                  
The plus feature is added to the original Massage Midwest 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.  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 (3) month period
per primary membership.

By my signature below, I agree with the terms of this agreement.

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.
On-line Club Midwest Form