Cancellation Form

Cancellation Form
Name

First Name Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Today's Date

Month Day Year
Date
Picking a Cancellation Date:
- If you are on a monthly membership with autopay you will have access to the gym until the end of the month you're canceling in regardless of what day you pick.
- You will not be refunded money or given credit for any days remaining in the month.
Last Day of Membership

Month Day Year
Date
Reason(Please be honest so we know how to improve):
If you are moving, where are you moving to? (Future location suggestions)
- By canceling your membership you understand that you are responsible for paying any and all fees associated with restarting your membership in the future.
Please verify that you are human *
Signature

Clear
Should be Empty: