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SESSION SHARE PERSON FORM

I would like to:
If adding a person, I would like this change to be:
Temporary Share for 1 Visit with $10 Transfer Fee (Relationship is removed after visit)
Ongoing Share with a Family Membership Add-on (Relationship is removed upon completion of this form)

ADDING A SESSION SHARE PERSON TO MY ACCOUNT

By submitting this form to add a Session Share Person to my account, I acknowledge and agree that the designated individual will have full access to all applicable active and prepaid service options associated with my account. I understand that this access will remain in effect until such time that I complete and submit a new Session Share Form to modify, revoke or update their access. I further acknowledge that unless and until such a form is submitted and processed by VERDE Organic Body, the Session Share Form will continue to have unrestricted access to utilize any and all prepaid service options available under my account.


REMOVING A SHARE PERSON

By submitting this form to remove a Session Share From my account, I acknowledge and agree that, effective on the date specified above, the individual listed will no longer have any access to my prepaid service options or other membership benefits. I understand that to add a new Session Share Person in the future, I must complete and submit a new Session Share Form Form for approval and processing.


ACKNOWLEDGMENT AND AUTHORIZATION

By signing below, I confirm that I have read and understood the terms outlined above and that I voluntarily authorize VERDE Organic Body to proceed with the addition or removal of the Session Share Form as indicated on this form. I affirm that I am the primary account holder and have full authority to make this request.

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