Extension Request Form Submission

Pleasanton Mach Martial Arts Extension Request Form

Submission of this request does not automatically mean that extension(s) will be approved/applied.
1. Membership Extensions:

a. Must be submitted for 1 week or longer.

b. If you submit an extension for longer than 1 month, please keep in mind that your membership rate will no longer be grandfathered in and you will be charged at the going rate of when you resume classes.

NOTE: You are eligible to make up missed class (see Class Make Ups for further details at Class Make Up Request

Submit your requests within 1 week of taking a leave of absence. You will not be eligible for membership extension if you fail to submit an extension request form on time. Late extension requests will not be accepted.
Student's Full Name*

First NameLast Name
E-mail*
example@example.com
Mach Martial Arts Location*

FremontPleasanton
I am a*
Dates you will be absent (Please enter From and To dates)*
Reason for absence*
Upload File Here

Click to upload
Valid Doctor's Note, or Documentation for Emergency situations. For school holidays, this is not mandatory. Cancelof
I acknowledge that my extension request is 1 week or longer. I acknowledge that IF my extension request is longer than 1 month, my membership rate will no longer be grandfathered in and I will be charged at the going rate of when I resume classes.*

Clear
Signature of parent if the student is a minor.
Should be Empty:

Pleasanton Mach Martial Arts Extension Request Form