Cancellation Form

Cancellation Form
Name

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

MonthDay Year
Date
Are you a Master Account Holder?

Yes, Master AccountNo, shared member
If you are a shared member: Name of Master Account holder.

First Name Last Name
If you are a shared member: Phone number of Master Account holder.
Please enter a valid phone number.
If you are a shared member: Email of Master Account holder.
example@example.com
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

MonthDay 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: