Name *

First Name

Last Name

Phone Number *

(###)

###

####

Date of Wedding *

MM

DD

YYYY

Desired Appointment Date *

MM

DD

YYYY

Alternative Appointment Date *

MM

DD

YYYY

Desired Time *

Hour

Minute

Second

AM PM

*

Blush & Raven Bridal Boutique (the Company) and their staff will at all times respect the confidentiality of the Personal Information placed in its care. The Company will endeavour to ensure that the policies affecting the collection, storage and disclosure of Personal Information reflect the confidential nature of the information. The Company will comply with all applicable privacy legislation and regulations in force now and in the future related to protecting the confidentiality of Personal Information. We carry many exclusive designers to our city and to respect the privacy & copyright of their designs, we do not allow outside guests to take pictures of the dresses in the boutique unless approved by your stylist. Blush & Raven reserves the right to any photos taken within the boutique and by checking the box below you acknowledge that these photos will not be released to any third party or used for any media purposes. By checking the box below and submitting this form, I acknowledge that my credit card will not be charged at the time of submitting my appointment request, but will be charged the booking fee of the appointment tier I have selected upon the time of securing my appointment. I understand that this fee is not refundable, in the case that I cancel my appointment. I agree to allow Blush and Raven to charge a $100 plus GST fee if my appointment is cancelled within 24 business hours, or in the case that I do not show up to my appointment, or any future appointment, without providing them with adequate notice. I also agree, if I choose to purchase a gown elsewhere within this 24 hours of my scheduled appointment, I forfeit my appointment and understand I will be charged the $100 plus GST fee.