Please copy and paste this form into a word document, fill in the blank areas with your information and membership option, and email it to or drop it into the "Get In Touch" page email form. Thank you!
Membership Agreement: This membership agreement between Nourishment Nutrition and (Member Name) becomes effective on (date). Payments will occur on the 1st of every month in the amount of $ with the membership option.
NOTE: YOU MUST HAVE HAD AN INITIAL CONSULT TO BE ELIGIBLE FOR MEMBERSHIP.
I'm Nourished:Two, 30 minute consults per month for $100.00 dollars
Beyond Nourished:Three, 30 minute consults per month + 5 new, personalized recipes for $160.00
Premium Nourishment:Four, 30 minute consults per month + updated meal plan, recipes, supplement guidance, and food tracking for $260.00
Terms of Membership Agreement:
Please copy and paste this form into a word document, fill in the blank areas with your information and membership option, and email it to or drop it into the "Get In Touch" page email form
By electronically filling in, signing and emailing this document you give Nourishment Nutrition, LLC permission to charge your card for the specified services on this form.
The initial membership period should be for a period of three months (the “Initial Period”). A member shall not be entitled to terminate or suspend his/her membership during the Initial Period.
After the Initial Period, the membership shall continue month to month. Either party may cancel this agreement at any time by giving written notice to the other party.
If you wish to make a payment using a form other than the card on file please contact Nourishment Nutrition at prior to the 1st of the month to make the alternative payment.
This Agreement is personal to the member and may not be assigned, transferred or otherwise disposed of by the member.
Applicants for membership must be at least 18 years old.
I, hereby agree to the Nourishment Nutrition Membership Agreement as stated above.
Credit Card Authorization
Card Holder Name:
Type of Card:
Card Number: - - -
Expiration Date: /
CVC (3 digits):
I hereby authorize Nourishment Nutrition, LLC to charge my card above per the aforementioned terms of this membership agreement.