Loading...

Membership Form

Agree to each section. 

I understand that the credit card on my file will be billed on the 1st of each month.  If that card fails to charge, my back up payment method will be charged.

I Agree

I understand that thirty (30) days written notice via email to customerservice@sugaredandbronzed.com is required if I would like to freeze or terminate my membership.

I Agree

I understand that I may not terminate or freeze my membership in the same month as sign-up or unfreeze request.

I Agree

I understand that accrued / rollover membership service benefits will not be available during the duration of a membership freeze.

I Agree

I understand that membership service benefits or rollover service benefits may be used for a lesser or equally priced service, but do not hold any cash value and may not be redeemed for multiple services with lesser or equal cash value.

I Agree

I understand that a no call / no show appointment is subject to forfeiture of the membership benefit for the scheduled service.

I Agree

I understand that my membership is non-transferable and that I will be asked to present a government issued photo I.D. to redeem membership benefits.

I Agree

I understand my membership rollover benefits expire one (1) year from the date of accrual.

I Agree

I understand that any unused/accrued membership service benefits will expire if and when the membership is terminated.

I Agree

I understand that all appointments are subject to availability and it is strongly recommended that I schedule appointments in advance.

I Agree

Date: July 3, 2020

Date: July 3, 2020

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

I understand that I am enrolling in the following membership program(s): 

Select all that apply.

Signature Membership: The Single
Signature Membership: The Double
Signature Membership: The Triple
Simple Sugar Membership: Sprinkle
Simple Sugar Membership: Teaspoon
Simple Sugar Membership: Tablespoon
Simple Sugar Membership: Scoop
Simple Sugar Membership: Ladle
If you have a card on file with SUGARED + BRONZED, would you like us to charge this card for your monthly membership billing?*
Yes
No, I'd like to schedule a phone call to setup a new payment method.
I don't have a card on file. I'd like to schedule a phone call to setup a new payment method.
Would you like your membership benefits to be effective immediately?*
Yes
No, I would like my membership to begin on the 1st of the upcoming calendar month.
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver