Membership Cancellation Form

To be filled out by member

Policy: To cancel your membership, you must submit this cancellation form at least 2 weeks prior to your next bill date. Memberships renew monthly based on your bill date (the original join date).

If notice is received less than 2 weeks before your bill date, your membership will renew for one final month, and cancellation will take effect at the end of the following billing cycle.

The termination of your health club membership and locker (if applicable) will be effective on your bill date once cancellation takes effect.

Note: If you choose to rejoin the club within one (1) year of cancellation, you will not be eligible for new member promotions, including complimentary personal training.

Scan # OR MGB ID # (if applicable)

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 at least 2 weeks prior to your next bill date. The termination of your health club membership and locker (if applicable) will be effective on your bill date once cancellation takes effect. (2) If I choose to rejoin the club within one (1) year of cancellation, I will not be eligible for new member promotions, including complimentary 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.