GYM ONE CANCELLATION REQUEST
Name
*
First Name
Last Name
Membership ID
*
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cancellation Date
*
-
Month
-
Day
Year
Date
Reason for cancellation (in paragraph)
Financial situation, health related, staff issues, facility issues
Attach supporting documents like medical certificate
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Terms and Conditions
Cancellation of subscription will start at the end of the month it was requested, assuming cancellation is requested prior to the 20th.
For paid in full accounts, there will be no refund after cancellation.
Cancellation will only be accepted via this form and not by phone or email.
Client's Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
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Authorized Use Only
Approved By
First Name
Last Name
Approver's Signature
Date Signed
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Month
-
Day
Year
Date
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