WILD Success

Wild Impact - Deferral Request Form

We acknowledge your request to defer your WILD IMpact membership. Please complete the form below so we can process your request quickly and accurately.

Full Name *

Note: Please enter the EMAIL ADDRESS you used to sign up for the Impact Program.

Email *

Deferral Request Details

I would like to request a deferral for my Wild Impact program. I understand the deferral period lasts up to three (3) months from my original start date and that my payments will continue as originally scheduled.

What is the Reason for your Deferral? *

Requested Deferral Period

Select which intake you'd like to defer *

Terms and Conditions

By submitting this form, I acknowledge the following:

I am eligible for only one (1) deferral for my program.
I understand that all coaching support and curriculum access will remain paused during the deferral period.
I understand that payments continue as originally agreed, and no refunds, credits, or extensions will be granted during the deferral period.
My request will be reviewed on a case-by-case basis, and approval is at the sole discretion of the program administrators.
If approved, the deferral must be activated within three (3) months from my original start date. After this period, no further delays will be granted.
Access to the program will automatically resume at the end of the deferral period or on my nominated restart date, whichever occurs first.
No further extensions will be granted once the three (3) months expire or if my nominated restart date has passed.

Signature

By signing below, I confirm that I have read, understood, and agree to the terms and conditions of the Wild Impact Program Deferral Policy.

Signature *

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