OTF Cancellation Request

Membership Cancellation Request Form

Cancellation Policy: Orangetheory Fitness employs a 30-day cancellation policy. A member can cancel at any time by filling out a cancellation form. Any EFT (membership fee) that is within the 30-Day cancellation period will be billed. The member has 30 days from the last EFT hit to utilize any unused sessions. Any class sessions remaining after the 30-Day cancellation date will be forfeited.
COMPLETED BY THE MEMBER
Member Name*
Phone Number*
Email*
example@example.com
Select Home Studio*
Today's Date

MonthDayYear
Date

SIGNATURES
I acknowledge that the cancellation procedures and dates have been explained to me and I understand that any EFT's (membership charges) remaining in the 30-Day cancellation period will be billed. I understand that I have 30 days from the last EFT hit to utilize any unused class sessions. After this time is over, I will forfeit any remaining class sessions as my membership will no longer be active.
Member Signature*

Clear
Date*

MonthDayYear
Date
COMPLETED BY THE STUDIO
Member Since*

MonthDayYear
Date
I have spoken to the member and discussed cancellation options and proceduresI have spoken to member about the termination date and informed them of any remaining class sessions.
Membership Termination Date*

MonthDayYear
Date
Last EFT Date*

MonthDayYear
Date
Number of Class Sessions Remaining*
Class Session Expiration Date*

MonthDayYear
Date
Manager Signature Approving Cancellation*

Clear
Date*

MonthDayYear
Date
Manager Name*
Should be Empty:

Rows	Great	Good	Fair	Poor	Unsatisfactory
Quality of the Workout
Front Desk Customer Service
Convenient Class Times
Cleanliness of Studio
Connection with Coaches
Overall Experience with Orangetheory

COMPLETED BY THE STUDIO