Orangetheory Membership Cancellation Request Northgate

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*
Format: (000) 000-0000.
Email*
example@example.com
Select Home Studio*
Who is your FAVORITE OTF Coach?*
Stetson/Academy/Northgate
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:

COMPLETED BY THE STUDIO