Student's Full Name *

Email *

Phone *

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

What's the reason for your cancellation? *

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

Rate your satisfaction with the facilities including equipment, parking and accessibility. *

Overall, how would you rate your experience? *

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

Comments

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

By providing my phone number, I agree to receive text messages from Gracie Barra Carlsbad. Messages will be appointment reminders, info about the facility, and occasional offers. Message frequency varies and message and data rates may apply. Text HELP for assistance. Text STOP to cancel anytime.