Cancellation Form

Cancellation Form
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
I'm canceling because:*

IllnessFinancial burdenMovingDo not useUnsatisfied with programs / serviceJoined another facilityOther
Explain:

Please help us improve our services by completing this brief summary:*

	Excellent	Good	Average	poor
Cleanliness of facility
Friendliness / Helpfulness of staff
Would you recommend symmetry Gym to your friends or family members?

I Understand that I will be charged one month beyond the date of this cancellation form. I have a 30 day window to rejoin without having to pay an enrollment fee. I Understand that I may continue to use the facility until the cancel date.
Date*

MonthDayYear
Date
Member Signature*

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