Schedule Appointment with THE KRXWN LOFT

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First Name *

Last Name *

Phone *

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
Monthly Unlimited House Calls	x $600.00	$600.00 per month
Total: $600.00

I agree to the terms and conditions set forth by Man Beyond The Mirror LLC. I will also be held responsible for any missed appointments by paying a no call/now show cancellation fee of $30 to make up for lost wages. Furthermore, Man Beyond The Mirror LLC is not responsible for honoring missed appointments by at fault clientele. Your missed appointment does not roll over to the next billing cycle. The entity is also not responsible for reminding you to come and receive services.