Student's Full Name *

Email *

Phone *

What's the reason for your cancellation? *

Is there anything else you'd like to share about your experience or why you are canceling?

Is there anything we can do to change your mind? *

How would you rate staff attention to your goals and needs? *

Overall, how would you rate your experience? *

How likely are you to recommend our gym to friends/family? *

By marking 'yes', I understand and agree that I must provide a 30-day notice to terminate my membership, if I have a scheduled payment within this 30-day period, the payment will be processed as scheduled. My access will end 30 days after my final payment. All payments are non-refundable. I may be subject to a new membership rates if I rejoin the gym at a later stage. *

Yes

By marking 'yes', I understand that submitting this form doesn't automatically cancel my membership. I also understand that a staff member will reach out to me to follow up, and that my requested cancellation date is subject to our gym's policies and procedures. *

Yes

If you are terminating your membership due to medical reasons or moving more than 25mi away from the gym, please upload proof to be released from the agreement