First Name

Last Name

Phone *

Email *

Membership Hold Duration *

Reason for Membership Hold *

I understand that my membership will be placed on hold 5 days from the date this form was submitted and all information is entered correctly.

I agree

I understand that all scheduled charges during my 5 day hold processing period will be processed as scheduled. All payments are non-refundable. *

I agree

I understand, Accounts will return to normal billing, at the new rate, after the hold expires. If you wish to cancel your membership during or after your hold, each member is required to complete a cancellation form. *

I agree

I understand, Iron Forged Coaching assumes no responsibility for inaccurately completed forms or forms not received due to errors outside of Iron Forged, Inc., control. *

I agree

Client Signature *

Clear