Cancellation Acknowledgment and Final Charge Authorization
By checking this box and my signature below, I acknowledge and agree to all of the following:
I am submitting a valid cancellation request today. Per my Membership Agreement, my membership terminates 30 days from today, and any membership dues or fees that fall within this 30-day period are valid and not subject to proration. I will continue to have full access during this period.
Consistent with my Credit/Debit Card Authorization, I authorize CrossFit Fortius to charge my card on file for any amounts that become due during this 30-day cancellation period, including my next scheduled bill if it falls within this period. I understand my revocation of card authorization becomes effective only after this 30-day period ends.
I agree not to dispute or charge back any charge that is consistent with the terms above and my signed agreements. If I inadvertently initiate a dispute, I will promptly inform my card issuer that the charge was authorized and valid under my Membership Agreement and Credit/Debit Card Authorization.
This acknowledgment does not waive my rights regarding unauthorized or fraudulent transactions. It confirms that charges assessed in accordance with the agreements I signed are authorized.