Membership Freeze Request
Anytime Fitness Club Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Member Name
*
First Name
Last Name
Member Email
*
example@example.com
Date Freeze to Commence
*
-
Month
-
Day
Year
Date
How many months would you like to freeze (there is no club access during a freeze)?
*
1
2
3
Other
Why would you like to freeze?
*
Please explain
Will you be travelling during the freeze?
*
Yes
No
If yes, where are you traveling to?
Please explain
I understand that I will not have access to my local Anytime or any of the 4500 Anytime Fitness’ worldwide while traveling.
*
Yes
No
I understand that I will be responsible for a $5 initial setup fee and that billing WILL commence as usual upon the freeze expiring.
*
Yes
No
I understand that my account must be in good standing to qualify for a freeze
*
Yes
No
I understand that if I wish to resume my gym activities early before expiration of the freeze, I must notify the Anytime Fitness Staff so my account can be unfrozen.
*
Yes
No
Member Signature
Submit
Should be Empty: