Membership Hold / Cancellation

1
Please enter your contact information* This field is required.
First Name
Last Name
Please enter your email
Please enter your phone
2
Membership Change* This field is required.Please select which membership option you are looking to request.
Hold
Cancellation
3
Please answer the following questions:* This field is required.
Please Select
Please Select
Moving out of state
Injury
Lack of attendance
Location is too far and / or relocating
Too expensive
Brief pause
What is the reason for leaving?
Please Select
Please Select
Excellent
Good
Average
Poor
How did our coaching staff attend to your needs?
Please Select
Please Select
Extremely
Very
Somewhat
Not at all
How satisfied were you with our facility?
Please Select
Please Select
Excellent
Good
Average
Poor
Please rate your overall experience.
Please Select
Please Select
Extremely
Very
Somewhat
Not at all
How likely are you to recommend us to others?
4
Cancellation Policy* This field is required.I understand that my membership will be canceled 30 days from the date this form was submitted. I acknowledge and accept the terms for cancellation.
AGREE
5
Hold Policy* This field is required.I understand that my membership can be put on hold for up to 90 days, which comes with a $59 hold fee per request. I also understand that any hold will extend the length of my membership agreement for the duration of the hold. (i.e. If I place a two month hold, my membership agreement will be extended two months beyond my original end date)
AGREE
6
Signature* This field is required.By signing this, I acknowledge that I have read and agree to all Dead Red Conditioning policies. I also agree to pay any overdue and / or owed balances prior to my 30 day cancellation. I acknowledge that if my payment is not made on time, that my account will be sent to collections and I will be responsible for all collections costs and attorney fees associated with that process.
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