Membership Cancellation

Membership Cancellation
How did you pay for your Membership?

12 - Pay (ACH) [Monthly payments automatically withdrawn from your checking account]3 - Pay [Paid for Membership in 3 monthly payments]1 - Pay [Paid for entire Membership]I don't know

Membership Cancellation

Memberships discontinued before the year is completed will be refunded on the basis of ½ of the unused balance plus a $5 service fee.

Please complete the form below. Cancellations may also be submitted via email to the Superintendent of Recreation at asigwalt@geneseoparkdistrict.org or by visiting the Geneseo Community Center in person to complete our cancellation form.
Name*

First NameLast Name
Email
example@example.com
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reason for Cancellation
Please sign below*

Clear

Membership Cancellation

Please complete the form below. Cancellations may also be submitted via email to the Superintendent of Recreation at asigwalt@geneseoparkdistrict.org or by visiting the Geneseo Community Center in person to complete our cancellation form.
Name*

First NameLast Name
Email
example@example.com
Phone Number*
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reason for Cancellation
Type a question*

Clear

We are sorry to see you go.

Someone from the Geneseo Park District will contact you with in 7 business days confirming your cancellation.

If you cancelled by mistake, please contact our office at (309) 944-5695 or by email at info@geneseoparkdistrict.org
Should be Empty:

12 - Pay (ACH) Users