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
*
Why are you leaving?
How would you describe your satisfaction with the coaching you received from us?
*
Extremely Satisfied
Extremely Satisfied
Very Satisfied
Moderately Satisfied
Slightly Satisfied
Not Satisfied at All
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How clean were the facilities?
*
Cleanliness was satisfactory.
Cleanliness was satisfactory.
Cleanliness was unsatisfactory.
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How satisfied were you with your overall experience?
*
Extremely Satisfied
Extremely Satisfied
Very Satisfied
Moderately Satisfied
Slightly Satisfied
Not Satisfied at All
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Would you recommend us to your friends?
*
Yes
Yes
No
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Additional Comments/Questions
I understand that this is a request to cancel and that the gym's policy on cancellation will be considered to determine final date of my membership
*
Yes
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