De-registration Form (Started 1st October 2020)

1
What's your first name?* This field is required.
2
What's your last name?* This field is required.
3
Thanks for that {PrimaryContactFirstName}. What's the best email address for you?* This field is required.
example@example.com
4
What is the name of the child you would like to deregister?* This field is required.
First Name
Last Name
5
Would you mind letting us know the reason you have decided to leave?
Huge
Large
Normal
Small
Ok
Ok
6
When joining Benchmark Gymnastics you agreed to our Terms of Leaving. Our Terms of Leaving state that if this form is submitted between the 1st and 17th day in the month, this will be the final month you make a monthly payment for class fees, provided you have no outstanding fees. You are entitled to attend classes as normal up until the end of the calendar month you pay for and no further payment will be due, provided you have no outstanding fees. If you submit this form between the 18th day of a month and the last day of a month, a final monthly payment will be collected by Go Cardless on or around the 4th day of the following month, provided the following month is not August. In this case, you will be entitled to attend classes for the remainder of this month and all of next month. With this in mind please select the date of the last class your child will attend
Date
Day
Month
Year
7
Digital signaturePlease enter your initials here.
Should be Empty: