your registration!

Step 1:

Step 2: To get the latest information and

updates, like us on FACEBOOK.

Step 3: Complete each field below

1.  Please share your contact information.

 

Name:

Street:

City:

ZIP Code:

Best Email address:

Cell Phone:

2. From which site did you purchase your daily deal?

Buy With Me

Deal On

GroupOn

Living Social

Weekly Plus

3. Redemption Code (Located underneath the barcode on the lower right of the coupon.)

4. What goals would you like to achieve by the end of the promotion?

5. IMPORTANT: Your credit card is required to hold your appointment spot. We have a 24 hour cancellation policy. If you do not show up or cancel your appointment within 24 hours of the scheduled time, your credit card will billed a “NO SHOW” fee of $10

Name on card:

Billing address:

Credit Card number:

Card expiration: MM/YY

Card security code (3 digit code located next to your signature):

We respect your email privacy

IMPORTANT:   You will receive an email shortly to schedule your 1st session.