Jetts Peregian members only - Cancellation form

MEMBERSHIP CANCELLATION FORM

Jetts Peregian members only
COMPLETE THE FORM BELOW TO CANCEL YOUR MEMBERSHIP.
jetts workout on your terms.
PERSONAL DETAILS
Name*

First NameLast Name
DOB*

DayMonthYear
Phone #*
Email*
example@example.com
Membership #
Membership date to be cancelled*

DayMonthYear
Date
Reason for cancellation

Breach of Club rulesWork commitmentsNot using ClubNon-payment of feesCan't afford feesDissatisfied with ClubMoving awayMedical reason
Other
ACKNOWLEDGEMENT
I acknowledge that by signing this form I will be stopping my Jetts membership access and direct debits. Where my notice is received by 5pm on a business day it will be processed with same day effect. Notice received after 5pm will be actioned the next business day. Any outstanding payments must be made prior to this cancellation taking effect. Where payments are up to date I shall have the right to use the club for the remainder of my pre-paid period.
Member's signature*
Today's date:*

DayMonthYear
Confidential All Rights Reserved : F122V3.04022014
Should be Empty:

jetts workout on your terms.