Membership Cancelation Request
Name
*
First Name
Last Name
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Home Club (Where you signed up)
*
Dewitt
Liverpool
Reason for Canceling
*
Can no longer afford
Moving out of the area
Joining another facility
Other
If you're joining another facility, would you mind telling us which one and why?
Membership cancellations require a 30-day notice, you will be responsible for any payments due in the 30-days following your submission of this request. If there are any issues with your request, a member of the management team will reach out to you to resolve those issues ASAP. By completing this request you indicate that you understand you will not have access to the club’s facilities or programming until that time which you choose to activate a new membership with us (and this extends to any secondary members associated with my membership account) and I will be subject to any relevant enrollment fees and the then-current dues structure at that time.
*
I understand and accept.
I do not understand/accept.
Submit
Should be Empty: