Membership Freeze Form

To be filled out by member

Please note, all freeze requests must be lined up with your monthly bill date.

Policy: Members may freeze an account for up to 3 months per calendar year for a fee of $10/month or $20/month if renting a locker. Normal rates will be resumed automatically at the end of the freeze period.
In order to freeze your membership, we must receive the below form 3 days in advance of the first month your freeze is desired.

*MGB members cannot freeze their membership. If you have questions, please email us here.

Scan #

Name

First Name

Last Name

Phone

(###)

###

####

Freeze Start Date

Must be 1st day of next billing cycle

YYYY

Reactivation Date

Must be 1st day of next billing cycle you wish to resume

YYYY

I hereby request that The Clubs at Charles River Park freeze my health club membership in accordance with the terms stated in my membership agreement. I understand that per The Clubs at Charles River Park freeze policy, I may freeze my account for up to 3 months per calendar year. During the freeze period my membership dues will be reduced to $10/month or $20/month if renting a locker, and normal rates will be resumed automatically at the end of the freeze period. I acknowledge that during the freeze period I will not be allowed to use the health club.

*Members on medical leave must cancel their membership during their period of inactivity. We will require a physician's statement in order to rejoin without a penalty. INITIAL HERE

ANNUAL Memberships Only

Total Number of Months (freeze):

Total Number of Months (locker):

Do you have a locker?

If yes, locker #