Wellness Package Registration Form

Wellness Package Registration Form
Please provide your information below, select your program(s), submit payment information and review & sign our policy agreement.

Thank you!
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Are you a JCC MetroWest member?

Payment

Choose program(s) (CHECK BOX) and select member or nonmember pricing:

Physical Therapy Transition Program

select MEMBER or NONMEMBER pricing

$245.00 Quantity

Healthy Start Program

select MEMBER or NONMEMBER pricing

$199.00 Quantity

Health & Wellness Coaching - 1 session (30 minutes)

select MEMBER or NONMEMBER pricing

$51.00 Quantity
Item subtotal:

Health & Wellness Coaching - 1 session (60 minutes)

select MEMBER or NONMEMBER pricing

$85.00 Quantity
Item subtotal:

Health & Wellness Coaching - 4 sessions (30 minutes)

select MEMBER or NONMEMBER pricing

$199.00 Quantity

Health & Wellness Coaching - 4 sessions (60 minutes)

select MEMBER or NONMEMBER pricing

$332.00 Quantity

Health & Wellness Coaching - 8 sessions (30 minutes)

select MEMBER or NONMEMBER pricing

$398.00 Quantity

Health & Wellness Coaching - 8 sessions (60 minutes)

select MEMBER or NONMEMBER pricing

$648.00 Quantity

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Total

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Expiration Month	Expiration Year

Wellness Program Policy Agreement

Payment
Payment for any wellness session(s) must be received prior to scheduling the session(s).

No Refunds or Credits
Wellness sessions are non-transferable and non-refundable.

Deadline for Package Use
Package sessions must be used within three (3) months from the date of the first session.

Tardiness
We encourage you to be on time for your wellness sessions. Sessions will begin promptly at the scheduled time. If you arrive late, you will receive the remaining scheduled session time. Please be advised that our Coaches are only required to wait fifteen (15) minutes after your scheduled appointment. After the fifteen (15) minute waiting period, your session will be considered a "no show" and redeemed as a completed session.

Cancellations
In the event you would like to cancel or reschedule your coaching session, you must contact your coach at least twenty-four (24) hours prior to the time of your appointment; otherwise, your session will be considered a "no show" and redeemed as a completed session.

Conduct
Without exception, minors are required to have their parents/guardians attend all wellness testing appointments.

Communications
You can contact our coaches by email and phone and our coaches will follow up as they deem appropriate. All electronic communication between a coach and minor will be copied to the parent/guardian. Texting is not permitted in communicating with minors, and we recommend no texting to any client, other than appointment confirmations.

We recommend that all participants complete a physical examination with their physician prior to engaging in any wellness sessions purchased hereunder.
Please review and check that you agree with the following:

With respect to Member’s voluntary participation in any physical activity or exercise program conducted in, on, around, about, or outside of the Center (the “Exercise Activities”), Member understands that there may be health risks associated with the Exercise Activities requiring physical exertion, including but not limited to transient dizziness, fainting, nausea, muscle cramping, musculoskeletal injury, sprains and strains, heart attack, stroke or death, as well as contraction of COVID-19 and other infectious diseases. Member assumes full responsibility for any and all injuries, illnesses or damages from the risks of his/her participation in the Exercise Activities.
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Wellness Package Registration Form

Payment

Choose program(s) (CHECK BOX) and select member or nonmember pricing: