Priority Experience Membership Please fill out the membership form below. CommentsThis field is for validation purposes and should be left unchanged.Date of Consultation(Required) MM slash DD slash YYYY Guest InformationFull Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email(Required) Phone(Required)THE PARLOUR PRIORITY EXPERIENCEYour Access, Defined THE RITUAL One Bioprogramming Restorative Blowdry per month — $99 (a $250+ value), available in any month where another Parlour service is booked and completed. THE WELCOME EDIT A signature Parlour swag bag at your first appointment, plus surprise luxury upgrades for inaugural members. THE INSIDER ACCESS Early access to new products, luxury devices, and seasonal booking calendar openings before the public. THE GUEST LIST Private invitations to VIP events, launch previews, and curated Parlour experiences. THE PARLOUR PRIVILEGE 5% off retail products and 5% off color services — every visit, every season. THE PARTNER PORTFOLIO Up to 25% off with our trusted wellness and beauty partners, including The Tox, Wellthy Method, and R3 Medhouse.FINE PRINT & TERMSBy enrolling in the Parlour Priority Membership, you acknowledge and agree to the following: Membership is $99 per month with a six (6) month minimum commitment. By enrolling, you are committing to the full six-month term (total value: $594). The $99 monthly fee is charged regardless of usage. Membership dues are billed each month whether or not services are redeemed. The membership includes one (1) Bioprogramming Restorative Blowdry per month, valued at $250+. The Bioprogramming Ritual is valid only in months where another Parlour service is booked and completed within the same billing cycle. The Bioprogramming Ritual may not be redeemed as a standalone visit and must be paired with another service (color, extension maintenance, treatment, etc.) in the same month. The monthly Bioprogramming benefit is non-transferable and does not roll over. Unused benefits expire at the end of each billing cycle. All services must be booked in advance and are subject to availability. Membership benefits are non-transferable and may not be shared or gifted. Membership dues are billed automatically to the card on file each month. If a payment is declined, reversed, or otherwise fails, the Member remains financially responsible for the full six-month commitment. In the event of non-payment, Parlour FL may suspend benefits and charge the card on file for any outstanding balance owed under the six-month term or invoice the remaining balance. Early cancellation does not release the Member from the six-month financial obligation. After the initial six-month term, the membership renews month-to-month unless canceled in writing with 30 days’ notice. Retail and service discounts may not be combined with other promotions or offers. Partner perks (including The Tox, Wellthy Method, and R3 Medhouse) are independently managed and may change or vary in value up to 25%. Parlour FL is not responsible for third-party services. Parlour FL reserves the right to modify or discontinue the membership program with notice.Consent I understand that the Parlour Priority Membership is a six-month commitment totaling $594. I agree that I am financially responsible for the full six months regardless of usage or early cancellation. I understand that the $99 monthly fee is charged whether or not services are redeemed and that the Bioprogramming Restorative Blowdry is valid only in months where another Parlour service is booked and completed. I authorize Parlour FL to charge my card on file for all membership dues owed under this agreement.SignatureType Full Name Below to Acknowledge and Agree.(Required)By typing my name above I acknowledge this agreement; I confirm that I have read and understood all policies and disclaimers outlined above and agree to be legally bound by the terms. Δ