Athletic Club Written Request Form

Request edit access

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Please fill out this written request form with ALL of your information and your intentions with your membership so our front desk staff can manage your account accurately.

*THIS FORM IS NOW A COMPLETE ONLINE VERSION OF OUR IN-PERSON, IN-WRITING VERSION OF OUR WRITTEN REQUEST FORM.

Email *

Member Name *

Phone Number *

Add On Member(s) Name

What would you like done to your account? *

Cancellation - *REMINDER* A 30-DAYS NOTICE is required to process a membership cancellation, and your balance must be paid off. You may choose to pay an additional $25 to have the cancellation expedited and have it processed in 24 hours.

Freeze - THIS IS TEMPORARY (Minimum of 30 days / Maximum of 12 months) *BILLING WILL RESUME AFTER 12 MONTH MAX*

Transfer Membership ($25 fee per change)

Other:

Start date of request: *

YYYY

End date of request (FREEZE ONLY): (If left blank, it will be automatically set to 12 months)

YYYY

Reason for request:

1. I acknowledge that this request is to be submitted at least 30 DAYS PRIOR to the next billing date on my account. (INITIALS) *

2. Adding additional members to current memberships that are not "in agreement" are subject to processing fees of $25.00 to add and subtract from memberships. (INITIALS) *

3. I acknowledge that I get a 1 time per year free Freeze Request. Thereafter, I acknowledge there will be a $25.00 charge for any additional freezes. Freezes have a minimum of 30 days and a maximum of 12 months. (INITIALS) *

4. I acknowledge that billing will resume after the 12-month freeze limit and that I will be billed regardless of membership usage. I acknowledge that only cancellation of membership will stop any further billing. (INITIALS) *

5. If this form is not fully initialed or completed, I am aware that my request will not be processed. (INITIALS) *

Today's Date *

YYYY

Any Additional Comments?

A copy of your responses will be emailed to the address you provided.

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