ABC Billing - Member Update Request

member name*

First NameLast Name

key fob #*

alphanumeric digits

best contact number*

member email*

request confirmation will be sent

To Update Member Billing Information, please dial ABC: 1-888-827-9262
-or- update directly on our new Anytime Fitness member app!

member updates*

updated phone number*

updated member name*

First NameLast Name

updated address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

referral member name*

First NameLast Name

referral key fob #*

alphanumeric digits

referral incentive

select free month*

renewal terms*

12 mo renewal incentive

24 mo renewal incentive

Member Freeze Option
Please select the start date and duration of your membership freeze below. Memberships can be frozen for $9 per month once per membership term, for a period of up to two months.

Please provide at least one week notice for processing.

freeze start month*

freeze duration*

monthly freeze rate

Monthly Tan Rate

monthly tan dues

Monthly Tan Rate

add unlimited tanning (select all)*

refund request

Refund Requested

reason for refund

details

additional notes

details

member signature*

staff name

staff position

staff email

owner

authorized by

reply to