We hate to see you go. Please fill out this form and we will be in touch with you shortly to finalize cancelling your membership.

First Name *

Last Name *

Phone *

Email *

Reason for leaving *

Rate your experience

Cleanliness Rating

Would you recommend us to family or friends?

Yes

Additional Comments or Concerns

Before submitting your cancellation request, please review and confirm the following:

30-Day Notice Requirement I understand that I am required to provide 30 days' notice prior to canceling my membership, in accordance with the Centerline Fitness & Performance Program Service Agreement I signed.

I acknowledge

Payments During the 30-Day Cancellation Window I understand that if a scheduled payment is due within my 30-day cancellation period, I am still responsible for completing that payment.

I acknowledge

I understand that this is a 'request to cancel' my membership, and will be subject to the facility's cancel policy.

I understand

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