VSC Membership Freeze Form

Membership Freeze Request

Any member wishing to freeze their membership MUSt complete this form as documentation of the request. A request to freeze should be a minimum of 14 days.
Member/Child/Participant Name*

First NameLast Name
Guardian/Parent Name (if different than member/child)

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Date Freeze to Begin*

MonthDayYear
Date
Date Freeze to End*

MonthDayYear
Date
Medical Reasons?*

YesNo
Will you be traveling during the freeze?*

YesNo
If neither medical nor travel, what is the reason for the freeze?
Please explain
I understand that if I wish to resume my VSC activities early, before expiry of the freeze, I must notify the VSC Management so my account can be reactivated.*

YesNo
Member Signature
Should be Empty:

Membership Freeze Request