Gold Membership Cancellation Form

GOLD 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

City

Postal / Zip Code

E-mail*

example@example.com

Cell Phone*

Alternate Phone*

OTHER MEMBERS ON THIS PASS

Name*

First NameLast Name

Name

First NameLast Name

Name

First NameLast Name

Name

First NameLast Name

Name

First NameLast Name

Name

First NameLast Name

Name

First NameLast Name

Name

First NameLast Name

PASS INFORMATION

Current Pass Type*

Effective Date of Cancellation

MonthDayYear

REASON FORM CANCELLATION

Reason for Cancelling*

I understand that if I cancel my membership before I have met my annual commitment date, I will be charged a cancellation fee of double the monthly rate for my membership type. I also understand that if I cancel before I have met my commitment date, I will receive a prorated refund check minus the cancellation fee 10 days after the effective date of cancellation.

Signature*

Please Type Name Here*

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 do not receive the confirmation email, please contact Aaron Stover at astover@vwcparksrec.com.