30 Day notice for Cancellation
Members Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Membership ID # or Door Code
*
Any minor children 15 and under on the account (all adult and 16+ teen memberships must complete their own individual cancellation request.
Are you canceling just a child/ children’s membership? If so please list all kids to cancel below
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Yes, Please cancel all the children I have listed below but not my membership
No, Please cancel all of the children I have listed below as well as myself.
No children, please just cancel my membership only.
Minor Child's Name
First Name
Last Name
Minor Child's Name
First Name
Last Name
Minor Child's Name
First Name
Last Name
Minor Child's Name
First Name
Last Name
Email (correct address required for confirmation copy)
*
example@example.com
Please let us know why you are leaving us! This helps us when considering future improvement. Ty
*
Acknowledgment of Member to adhere to all terms and procedures laid out in the original agreement for the cancellation procedures. Member is aware and recognizes that their is a 30 day notice requirement for cancellation and if any payment that may still be required is revoked or does not process the membership will still continue and late fees will still occur.
*
Date
*
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Month
-
Day
Year
Date
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