Gym Cancellation Form
Gym/Branch Location
Name
First Name
Last Name
Membership ID
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cancellation Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for cancellation (in paragraph)
Financial situation, health related, staff issues, facility issues
Attach supporting documents like medical certificate
Browse Files
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Terms and Conditions
Cancellation of subscription will start at the end of the month it was requested.
For monthly payments, there will no refund after cancellation.
For yearly payments, a prorated monthly refund will be processed.
For medical or health issues, a medical certificate is needed for the cancellation to be approved.
Cancellation will only be accepted via this form and not by phone or email.
Client's Signature
Date Signed
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Â
Print Form
Submit
Authorized Use Only
Approved By
First Name
Last Name
Approver's Signature
Date Signed
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Should be Empty: