Membership Pause Request

First Name *

Last Name *

Phone *

Email *

Pause Date (billing date): If you are unsure, we will be happy to look it up for you. *

Resume Date

I acknowledge that the pause can only be applied on the membership billing date. If an incorrect start date is provided, Fit Haus staff will initiate the pause from the correct billing date, which may differ from the date I enter. The unpause date will remain as entered by me. I agree to pay a $15 pause fee per month or per pause, whichever duration is shorter. The pause fee will be waived only in cases of medical or injury-related circumstances. * *

Yes

Member Signature

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