First Name *

Last Name *

Email *

Phone *

Please select the option below that describes your reason for cancelling: *

I'm graduating (ready to do this on my own)
Relocation (I'm moving)
Injury, medical, pregnancy
Too Expensive (financial reasons)
Lack of Attendance (I wasn't coming enough)
Poor Service/Facility
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How well did our coaching staff attend to your fitness goals and needs? *

Extremely well
Moderately well
Not well
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What could we have done better to keep you as a member? *

How would you like to proceed with your cancellation? *

This form is submitted 30 days prior to my next charge.
Use my next charge for one more month of membership and cancel 30 days after that.
Use my next charge as an exit fee and cancel my membership.
I'm not sure, contact me directly.
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