Bronze Membership Cancellation Form

BRONZE PASS CANCELLATION FORM
275 Beasley Drive | Versailles, KY 40383
www.vwcparksrec.com | (859) 873-5948
- Requests for cancellations must be submitted at least 15 days prior to the date of draft.
- Any request received after 15 days will be processed the next month.
MEMBER INFORMATION
Primary Name of Membership*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Cell Phone*
Effective Date of Cancellation

MonthDayYear
Reason for Cancelling*
In understand that I can cancel my membership at any time without penalty. If I choose to reactivate my membership within 12 months I will be charged a $25 re-activation fee. I also understand that if I choose to re-actviate my membership after 12 months there will be no re-activation charge.
Signature*
Please Type Name Here*
Date

MonthDayYear
Date
After completing this form, please click "Submit" below. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam and/or junk folders. If you still did not receive the confirmation email, please contact Aaron Stover at astover@vwcparksrec.com.
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