Symmetry Cancellation Form

Symmetry Cancellation Form

We’re sad to see you go - but we hope to welcome you back soon!
Member Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Reason for Cancellation*

MedicalRe-locationNon-usageFinancesOther
Rate Your Overall Experience with training (1 is poor, 5 is great)*

12345
If there anything we could have done to improve your experience?
Important Acknowledgements

Please check all to proceed with your cancellations request:
I understand that if I am under a 3 month contract and have not completed it, my cancellation will go into effect after the 3-month commitment is fulfilled, as outlined in my membership agreement.*

Agreed
I understand that my membership cannot be cancelled while frozen. If I am currently on a freeze, one more autopay will be pulled to complete my final month before cancellation.*

I understand
I am provididng my 30-day written notice to cancel my membership. I understand that I am responsible for any remaining autopays within the next 30 days, per my contract.*

Agreed
Member Signature*

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Date*

MonthDayYear
Date
Thank you for being a valued part of the Symmetry Pilates community!

This may be a goodbye for now, but it doesn't have to be forever. If your schedule changes or you are looking for more flexibility, we offer punch passes or drop in-options that my suit you better. We'd love to see you again when the time is right!
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Important Acknowledgements