First Name *

Last Name *

Phone *

Email *

Begin Date *

Resume Date *

I understand that hold requests must be submitted no less than 5 business days prior to my forthcoming scheduled non-refundable renewal payment. I understand there is an $8 per week fee for Membership Holds. I understand that my membership and non-refundable payments will resume automatically upon exipration of the hold period that I have selected above. *

Yes