Clone of ITB Grand Opening RSVPs

1
Image Field
2
Name* This field is required.First + Last please!
First Name
Last Name
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.So we can keep you updated on important event details!
Please enter a valid phone number.
5
Which location will you be joining us at?* This field is required.This exclusive event will be hosted in both NC and VA.
North Raleigh 8300 Health Park
Richmond 8730 Stony Point
6
Will you be bringing a guest?* This field is required.Your guest does not need to be a FBV member to attend.
Yes
No
7
Please provide guest name, phone number and email addresses for your guest.Members may bring with them up to 3 non-members.
8
We will be offering Complimentary Peels along with Botox Treatments at $10.50/unit during the event, by appointment only. Would you like to be contacted to book a treatment slot?* This field is required.Treatments are available on a first-come, first-served basis with a $25 sitting fee that can be used towards purchases made during the event. Selecting YES does not confirm your appointment. You must get scheduled with a member of our team and your credit card must be on file. Non-member guests may receive the treatments during this event but they need to book an appointment as well.
Yes
No
9
By submitting this form, you agree to be contacted by phone, email or text and that any associated call may be recorded for quality and training purposes. In addition, I consent to receiving marketing and promotional messages from Synergy Face + Body in the form of SMS and phone calls and understand that standard messaging and data rates may apply. This form should not be used to transmit private health information, and we disclaim all warranties with respect to the privacy and confidentiality of any information submitted through this form.
Should be Empty: