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 *

Have you considered a pause of Membership?

Yes Pause

No I want to Cancel

Would you like for a staff member to contact you to discuss? *

Yes

Would you recommend us to your friends? *

When is your last requested date (pending staff/contractual review)? *

How satisfied were you with your overall experience? *

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

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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