Membership Status Change

Membership Status Change

Street Jitsu Justin
Date of Request

YearMonthDay
Date
Membership Freeze

Member may request their membership be frozen for up to 3 months and not have to pay the enrollment fee when member returns. A membership freeze is allowed after completing the initial membership terms. Each additional membership freeze is allowed 12 months after the last freeze. All membership freeze requests must be made 15 days or more before the next billing date.

A request to freeze in less than 15 days to the next billing date will result in a regularly scheduled membership payment drawn from the member’s payment method on the established auto draft date. The Freeze will then be allowed to take effect.

Member agrees to complete the monthly freeze payment for each member to maintain their membership with Street Jitsu Justin.

Should any regularly scheduled membership or freeze payments be missed a new agreement and enrollment fee will be required should you choose to return to training here at Street Jitsu Justin.
Membership Cancellation

As per the agreement signed at enrollment, all membership plans require a minimum of 30 days written notice “Request for Membership Cancellation” prior to next billing date to ensure cancellation of recurring payments.

Cancellation requests submitted in less than 30 days to the next billing date will result in a final payment drawn from the member’s payment method on the established auto draft date. Once final payment has been drawn from a member’s payment method, the member will have the remaining time based on the “Plan” selected to use the facilities.

It is the member’s responsibility to provide written notice 30 days in advance of the next billing date. There will be no refund issued once a payment has been received from the members payment method provided.

Should member cancel/terminate agreement for any reason, member agrees to pay remaining balance due for the “Plan” selected.

To cancel this Agreement, you must provide a Formal Notice of “Cancellation”, either:

1. By email to fighter@streetjitsujustin.com,

2. deliver a signed and dated written notice of cancellation by personal delivery to the gym; or

3. by registered or certified mail to: Street Jitsu Justin 17515 Matany Road, Building 1, Suite 1200, Justin TX 76247 or current address of business.
You may use the following form below to request a change in Membership Status. This information will be sent via email to fighter@streetjitsujustin.com.

You should receive notification of this email as well.
I am requesting the following change to a Street Jitsu Justin membership:*
I have read and understand the Freeze Policy above.*

Yes
I have read and understand the Cancellation Policy above.*

Yes
Student Name*
Student Contact Email*
example@example.com
Select date to initiate Cancellation of Membership?*

YearMonthDay
Year.Month.Day
Reason for Cancellation

Personal ScheduleNot for meOther
If "Other" selected, please provide details.
I authorize Street Jitsu Justin to schedule Membership FREEZE payments and return to Recurring Billing of Membership for the dates provided.

YES
Schedule date to initiate FREEZE of Membership?

YearMonthDay
Year.Month.Day
Schedule return date to END the FREEZE of Membership and return to training?

YearMonthDay
Year.Month.Day
Authorized Name*

First NameLast Name
Authorized Signature*

Clear
If you cancel your membership, an enrollment will be due if you wish to return to training at Street Jitsu Justin.

Or, you may FREEZE your membership for not more than 3 months.

There is a nominal fee ($10) charged each month your memberhsip is frozen.

The FREEZE fee must be scheduled.

The returning membership payment must also be scheduled.

You must agree to the scheduled payments.

Should a single payment be missed, the enrollment fee will be due if you wish to return.
Please request Cancellation of Membership!
Please understand that this is the very same Cancellation Policy that was agreed to on the Membership Agreement that was signed at enrollment.

You may request a copy of your Agreement at:

fighter@streetjitsujustin.com

Recurring billing will not be terminated until a written notice is received.

Select "Yes" if you do understand and wish to provide that written notice with this form.
Should be Empty:

Membership Status Change

You may use the following form below to request a change in Membership Status. This information will be sent via email to fighter@streetjitsujustin.com.