Language
English (US)
Training Agreement Freeze/Cancellation Form
Cancellation or Freeze?
*
Cancellation
Freeze
Staff Name
*
Please Select
Josh Moore
Jessica Moore
Hayley Bourque
Danyl Tyo
Bailey Sewell
Nabil Navodia
Christian Mihalides
Member Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Freeze Start Date:
*
-
Month
-
Day
Year
Date
Number of payments frozen:
*
Date of Payment Reinstatement:
*
-
Month
-
Day
Year
Date
Reason for Freeze
*
Medical
Re-location
Non-usage
Finances
Other
Reason for Cancellation
*
Medical
Re-location
Non-usage
Finances
Other
Rate Your Overall Experience with training (1 is poor, 5 is great)
*
1
2
3
4
5
Please explain.
Has the Staff been friendly and knowledgeable?
*
Yes
No
Please explain.
Did you achieve your health, fitness and nutrition goals?
*
Yes
No
Please explain.
Have you been making use of your sessions and attended regularly?
*
Yes
No
What comments or suggestions do you have regarding your training program?
What feedback or general suggestions or comments do you have to help us improve?
Type of Cancellation
*
30-Day's Notice
Agreement Buyout
10-Day Cancellation clause
I am providing Anytime Fitness my 30-day written notice to cancel my training agreement, as required by my agreement. I understand that I am responsible for any billing that will occur within the next 30-days.
*
Yes
I am providing notice of cancellation for my personal training agreement, as required by my agreement. I understand that I am responsible for paying off 50% of any remaining balance on my agreement.
*
Yes
I am providing notice of my 10-day cancellation for my personal training agreement, as required by my contract. I understand I will receive a full refund less any money owed for delivered sessions.
*
Proof of move, medical or other documentation attached
Browse Files
Cancel
of
Member Signature
Clear
Date
-
Month
-
Day
Year
Date
Submit
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