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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Phone
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Email
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Select the option 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)
Going a different direction with my fitness
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What is a challenge you are still facing when it comes to your health and fitness?
What has been your greatest change since going CrossFit Virilis?
What would you have wanted to see more of at CrossFit Virilis?
Would you recommend us to your friends?
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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
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Yes
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