Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date

MM

DD

YYYY

Time

Hour

Minute

Second

AM PM

Which Service Would You Like for Your Team? *

Corporate Wellness Services Boost focus, reduce stress, and support your team with on-site wellness experiences. Vibroacoustic Therapy (10–30 min) Relaxing sound + vibration on a reclined table with BrainTap headset. ✔ 1 provider, all equipment included ✔ 2-hour minimum | 15–20 min setup Chair Massage (10–15 min) Quick, effective stress relief at work. ✔ Up to 10+ therapists available ✔ 2-hour minimum | 15 min setup Group Yoga (10–20 participants) Breathwork + movement for mindfulness and calm. Mats provided. ✔ Indoor or shaded outdoor spaces ✔ 15–30 min setup

Vibroacoustic Therapy + BrainTap & Chair Massage

Chair Massage

Yoga

Vibroacoustic Therapy + BrainTap

Does your company need insurance: *

Silver Liner Mobile Massage Studio is a small business that exclusively hires independent contractors. As such, we do not carry workers' compensation coverage since we do not have employees. Before booking your chair massage, please select which endorsements you require so we can include them in the invoice. We will also need the following: Certificate Holder COI and the specific verbiage required. This will ensure we have everything ready in a timely fashion.

Primary, Noncontributory: Ensures our insurance is primary and will not seek contribution from other policies. Additional fee $25.

Specific Waiver of Subrogation: Prevents our insurer from seeking recovery from another party. Additional fee $25.

Loss Payee: Designates a third party to receive insurance proceeds in the event of a loss. Additional fee $25.

Primary, Noncontributory & Waiver of Subrogation: Combines the primary, noncontributory, and waiver of subrogation endorsements. Additional fee $45.

CG 20 37 Additional Insured – Owners, Lessees, or Contractors – Completed Operations: Provides coverage for completed work. Additional fee $30.

CG 20 11 Additional Insured – Managers or Lessors of Premises: Adds coverage for managers or lessors of premises. Additional fee $30.

Earlier Notice of Cancellation Provided by Us: Ensures earlier notice of policy cancellation. Additional fee $55.