Cancellation

Cancellation

Please fill in the form below.
Reason
Membership/Child Name

First NameLast Name
Member Code
Additional membership codes
Facility
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Notes
Click through for freeze and cancellation details

Freeze | Put membership on hold
On Hold Start Date

DayMonthYear
Date
On Hold End Date

DayMonthYear
Date
Last Payment Date

DayMonthYear
Date
Reason

Cancellations
Cancellation requires 4 weeks notice - Form must be signed
Date of Cancellation

DayMonthYear
Date
Minimum Term End Date

DayMonthYear
Date
Last Date of Access

DayMonthYear
Date
Last Payment Date

DayMonthYear
Date
Reason for Cancelling

Other
Reason
Signature
Should be Empty: