Modo Yoga LA Membership Cancellation Request
Your Be Awesome Membership request must be submitted 30 days before your next pre-authorized payment. Please provide the following information to request cancellation. Cancellation requests are processed within 48 hours and you will receive a confirmation email upon processing. (NOTE: Completing this form will not automatically terminate your membership, but submits your request for processing.)
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MEMBER FIRST NAME *
MEMBER LAST NAME *
MEMBER PHONE NUMBER *
MEMBER EMAIL ADDRESS *
MEMBER HOME STUDIO *
WHEN WOULD YOU LIKE THE CANCELLATION TO TAKE EFFECT? (Please note: Your cancellation date cannot be backdated.) *
MM
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DD
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YYYY
REASON FOR CANCELLATION *
*
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