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Bruxelles Suspension
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Suspension starts from
*
MM
/
DD
/
YYYY
Suspension ends the
*
MM
/
DD
/
YYYY
First & Last Name
*
Your answer
Email address
*
Your answer
Phone Number
*
Your answer
My membership is
*
Monthly payment Contract
Single Payment Membership
Please charge 20 euros suspension fee using the bank details recorded on my Yoga Room Profile
*
I agree
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