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Massage Membership Sign-Up Form

We are so excited for you to join our monthly massage membership! Please complete the online form below to sign- up for our massage membership program. Please contact us via call or text at (331)- 248-5777 for any questions. 

Monthly Massage Membership is $79.99

Includes one 60-minute massage, additional massage rates below (member)


Step 1- Give us a try! 

​Take advantage of our first time visit introductory rates, which are the same rates members pay.


 Step 2- Sign up! 

​Members pay a monthly reoccurring fee of $79.99 and receive a 60-minute massage each month your dues are paid.  All additional services purchased within the month will be at the low monthly membership rate. 

Step 3- Begin using the perks! 

Once you use your monthly massage enjoy the reduced rate on additional massages for being a member. Busy? Monthly massages can accrue and may be used later provided you remain an active member. Any unused accrued massages expire and are forfeited if not used within 30 days of official notification of membership cancellation.


Additional 30 Minute Massage $40.00 

Additional 60 Minute Massage $70.99 

Additional 90 Minute Massage $105.99 

Additional 120 Minute Massage $135.99 

Massage Room at Bucek Chiropractic
Are You Well Adjusted? 
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