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If you desire assistance or have questions about this form, you can email us at firstname.lastname@example.org, call us at (517) 483-4133, or visit us in the City Clerk's office, located on the 9th floor of City Hall (124 W Michigan Avenue, Lansing, MI 48933).
Fill out and print this form. Bring this form and the materials listed below to the City Clerk's office to complete the application process. This form can be notarized at the City Clerk's office.
This application is to be accompanied by plans and specifications of the quarters showing such details as entrances, partitions, windows, openings, ventilation, plumbing fixtures and water supplied. A copy of the insurance policy and proof of bond must be filed with the City Clerk at the time of application. There is a non-refundable fee of $200.
Health Club Name
For Public Liability up to $100,000 for injury or death of one person and for up to $300,000 for
injury or death to more than one person and for property damage in the sum of $100,000. (Copy
of policy must be filed with the City Clerk before a license will be issued.)
In the sum of $1,000. (Bond must be filed with the City Clerk prior to issuance of a license.)
Only a licensed massage therapist can provide massage services to members of the opposite sex.
If the applicant does not intend to provide massage services, indicate by signing after the following: "I do not plan to provide massage services."
DO NOT sign except in the presence of a notary.
Subscribed and sworn to before me this ________ day of ____________________, 20_______, acting in the County of ____________________, Michigan.
This field is not part of the form submission.
* indicates a required field