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 *Purchased by: (full Name)

  *Phone:

  *Email:

  *Gift for: (full Name)

  Special Occasion:

  Send Gift Certificate to: (address)

  City/State/Zip:

  *Recipient's Email:**

  *Recipient's Phone:

  Type of Massage:

Deep Tissue Medical Massage Swedish Shiatsu Pre-Natal Acupressure Reiki Chair Massage

  Duration/Rates:

Half Hour One Hour One and a Half Hour Two Hour Couples Massage ((specify duration below))

  Comments, questions:

  **Note: If not enough time for mailing, I will send an electronic certificate and trust that the money will be forthcoming. The gift will not be recognized until it is paid for in full.

  We only accept cash or personal checks. Please make checks payable to:

Massage of Boulder Creek
Send to: Karen Moore
786 Creek Dr.
Boulder Creek, CA 95006
Tel: 831-338-WELL (9355)