Membership Suspension Form
Please be informed that you can suspend your membership twice a year for a minimum of 15 days up to 3 months for both periods combined, except health condition reasons. Your request will be evaluated and you will be notified via contact details below.
Client Information
Full Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Suspension Details
Start Date
-
Month
-
Day
Year
Date
End Date
-
Month
-
Day
Year
Date
Please specify your reason for suspension
I want to suspend my membership due to health related condition.
Please upload doctor signed medical report about your recent health condition:
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Client Acknowledgement
By signing this form, I hereby acknowledge the suspension procedures.
Please sign here
Submit
Submit
Should be Empty: