Cancellation/On Hold Form

Cancellation/On Hold Form
Athlete Information
Customer Account Name

First NameLast Name
DOB

MonthDayYear
Date
Gender

MaleFemale
Home Number
Cell Number
E-mail
example@example.com
Membership Type
Type a question

CancellationOn hold
Please provide a brief description of why you would like to cancel or put your membership on hold.
Cancellation/On Hold Policies

1.) MEMBERS MAY HOLD THEIR MEMBERSHIP FOR PERSONAL OR MEDICAL REASONS, PAYING ONLY 10% OF THE REGULAR MEMBERSHIP FEE. THE HOLDING TERM WILL BE A MAXIMUM OF 3 MONTHS, AFTER THAT THE MEMBERSHIP WILL BE AUTOMATICALLY ACTIVATED.

2.) IF THE MEMBER WISHES TO CANCEL THEIR MEMBERSHIP, THEY MUST PROVIDE 30 DAYS’ NOTICE IN WRITING PRIOR TO CANCELLATION AND AFTER THE EXPIRATION OF THE TERMS SET FORTH BY THEIR CONTRACT. PRIOR TO THE TERMINATION DATE THE MEMBER MUST PAY ALL AMOUNTS OWED ON SAID ACCOUNT TO THE CLUB IN FULL.

3.) IF THE MEMBER DOES NOT TERMINATE THEIR MEMBERSHIP AS SET FORTH IN THE PRECEDING PARAGRAPH, THE MEMBERSHIP WILL BE AUTOMATICALLY RENEWED ON A MONTH-TO-MONTH BASIS AT THE EXPIRATION OF THE TERM SET FORTH ABOVE. THE MEMBER WILL BE OBLIGATED TO PAY MONTHLY DUES, REGARDLESS OF WHENEVER HE OR SHE USED THE CLUB FACILITIES, UNTIL THIRTY (30) DAYS AFTER THE CLUB HAS RECEIVED WRITTEN NOTICE OF TERMINATION.

4.) IF A MEMBER WISHES TO REACTIVATE THEIR MEMBERSHIP, THEY WILL HAVE TO PAY THE INITIATION FEE AGAIN AND FILE A NEW MEMBERSHIP APPLICATION.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Signature

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Cancellation/On Hold Form

Athlete Information