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
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Last Name
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Email
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Phone
Please select the option below that best describes your reason for leaving.
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Location (Not Convenient or Relocating)
Too Expensive (Financial Reasons)
Location (Not Convenient or Relocating)
Difficulty (The workouts are too hard)
Injured (I am injured)
Lack of Attendance
Maternity (I am pregnant)
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Did you enjoy your time at Rebuilt Fitness?
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Yes!
Extremely Satisfied
Very Satisfied
Moderately Satisfied
Slightly Satisfied
Not Satisfied at All
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Would you recommend us to your friends?
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Yes
Yes
No
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Additional Comments/Questions
I understand that I agreed to our billing policy that I have to cancel my membership 15 days before my billing date and if I do not, I have to pay for the next month of my membership.
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Yes
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Submit My Cancellation
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