Billing Dispute Forms

How can we help you?*

We kindly remind you that it is each Member’s responsibility to timely review the account statement and to dispute in writing any charge believed to be in error. After 60 days from the month end statement date, any charge not disputed is deemed valid and will not be reversed. Thank you for your membership.

Name*

First NameLast Name

Membership number*

Your Home Club*

Club the charge was made at (if not your Home Club)

Department*

Ticket number*

Ticket date*

Billing question details*

Amount of charge*

Best email address to contact you*

example@example.com

Best phone number to contact you*

Please enter a valid phone number.