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 *

Last Name *

Phone *

Email *

Select the option that best describes your reason for leaving. *

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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How would you describe your satisfaction with the coaching you received from us? *

Extremely Satisfied

Extremely Satisfied
Very Satisfied
Moderately Satisfied
Slightly Satisfied
Not Satisfied at All
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Would you recommend us to your friends? *

Yes

Yes
No
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How satisfied were you with your overall experience? *

Extremely Satisfied

Extremely Satisfied
Very Satisfied
Moderately Satisfied
Slightly Satisfied
Not Satisfied at All
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How clean were the facilities? *

Cleanliness was satisfactory.

Cleanliness was satisfactory.
Cleanliness was unsatisfactory.
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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 *

Yes

Additional Comments/Questions

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