Yoga MEMBERSHIP - PAUSE OR CANCELLATION
Any questions or concerns please contact me at susan@hummingbird-yoga.ca or 778-350-4370
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Cell phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Pause or Cancellation Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Restart Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Confirmation of membership you wish to cancel:
Monthly Membership (unlimited live classes and access to replay library)
Yes I want to resume my ongoing monthly membership renewal.
Yes
No
Reasons for Cancellation or Pause. If restart date is unknown you can resubmit a Registration Form at any time.
Signature
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