Membership Cancellation Form

To be filled out by member

Policy: You must fill out our cancellation form 2 weeks in advance of the last month membership is desired. The termination of your health club membership/locker will be effective the last day of your billing period.

If you choose to rejoin the club up to one (1) year after cancellation of this contract, you are not eligible to receive new member personal training.

Scan #

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Why are you canceling your membership?

What areas of interest can we change to better serve our members:

group fitness classes

cardio equipment

free weights

strength training machines

locker rooms

personal training

swim lessons

indoor pool

outdoor pool

Explain:

(1) I understand that all membership/locker cancellations are effective at the end of a billing period and to cancel my membership I must fill out the CCRP cancellation form 2 weeks in advance of the last month membership is desired. The termination of my health club membership/locker will be effective the last day of my billing period. (2) If I choose to rejoin the clubs up to (1) year after cancellation of my membership, I will not be eligible to receive new member personal training.

Initial here

Do you have a locker?

If yes, locker #

One day after your expiration date your belongings in the rental locker will be disposed of.