Refer a friend and get 50% off a core service
Signed in as:
filler@godaddy.com
Notice to Members and Customers:
MEMBERS AND CUSTOMERS::
Do not sign this agreement before you have read it in its entirety. The member/customer is entitled to a completed copy of this agreement. The member and customer acknowledges that this document is an agreement and will become legally binding upon its acceptance by The Whole Path. .
Any member/customer, 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 The Whole Path membership 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 therapists cannot diagnose or treat 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 The Whole Path at the time of service.
Disclaimer
The Whole Path is not responsible for any injury or loss of property to any person while on the premises or participating in The Whole Path’s services. As a member, I assume full responsibility for services received at The Whole Path and shall indemnify The Whole Path, its affiliates, agents, and employees against any and all liability arising from services rendered.
MEMBERS:
The undersigned member acknowledges receipt of The Whole Path membership terms and conditions and has read, understands, and agrees to be bound by the terms and conditions as part of this agreement
The member also understands there will be no refunds issued for any charged [member] dues.
The undersigned member acknowledges receipt of The Whole Path membership terms and conditions and has read, understands, and agrees to be bound by the terms and conditions as part of this agreement.
Monthly Membership Dues
Membership dues will be automatically charged to member’s bank account/credit card on the anniversary day of every month.
Card Information
Card Number: Cardholder Name:
CVV2 Code/CSC # (if any):
Member Signature:
Signature of Parent or Guardian: Witness Signature:
Expiration:
Card Type: MC/ VISA/ AMEX/ DISCOVER
Billing House Number:
Billing Zip:
Date: Date: Date:
Membership Terms and Conditions