Name
*
First Name
Last Name
Email Address
*
Phone/Mobile Number
*
Date of Birth
-
Day
-
Month
Year
Date Picker Icon
Which Membership would you like to join?
*
prev
next
( X )
Lash Addicts Gold Mega Volume Membership
(
$
65.00
AUD
for each
week
)
Lash Addicts Silver Membership Hybrid/Soft Volume
(
$
55.00
AUD
for each
week
)
Lash Addicts Bronze Membership Classics
(
$
35.00
AUD
for each
week
)
Rose Quartz Ultimate Self Love Membership
(
$
190.00
AUD
for each
week
)
Email
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Which salon you want to go?
Ipswich Salon
Paddington Salon
Terms and Conditions Apply
Submit
Should be Empty: