Schedule Appointment with GLOW REFINERY

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

Item	Quantity	Total
Diamond Glow Member	x $250.00	$250.00 per month
Total: $250.00

I agree to the terms and conditions on www.glowrefinery.com and give GLOW REFINERY LLC authorization to charge my credit card monthly for membership dues.

By purchasing packages, I give consent to GLOW REFINERY LLC to auto debit my card monthly for package/s or membership purchased, until payments fulfillment or membership cancellation.

I understand that packages and membership are non-refundable and non-transferable under any circumstances. Only one Facial allotted per month. If a customer misses or neglects to schedule an appointment in any given month, that facial cannot be transferred to the next month. No exceptions.

BY PURCHASING A PACKAGE, YOU AGREE TO RELEASE GLOW REFINERY OF ANY LIABILITY INCLUSIVE OF ALLERGY REACTION TO PRODUCTS.