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Book Mobile Reflexology
Name (first & last)
Email
Cellphone Number:
What is the physical address where you woul like to have your reflexology session?
Is this address:
a private residence
a workplace
a community centre
other
Day, Date, Time:
How many reflexology treatments would you like to book in for this visit?
It's just me - $85.00
Myself and 1 other person - $160.00
Myself and 2 other people - $225.00
Is this the first time you have had reflexology with The Relaxation Room?
No
Yes
How will you be paying for your reflexology treatment?
Internet Banking
Credit Card
Send
Register your interest to attend a sleep workshop.
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Your Name:
Your Email:
Your cell phone number:
I would like to register my interest to attend a Reflexology Sleep Workshop.
I understand that another person will be touching my feet.
I understand that I will need to touch another person's feet.
I would be interested in attending in:
Palmerston North
Levin
Feilding
Other
Where would you prefer to attend?
Send