Membership Cancellation Form
Staff Name
*
Please Select
John Doe
Jane Doe
Member Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Reason for Cancellation
Medical
Re-location
Non-usage
Finances
Rate Your Overall Experience at Anytime Fitness (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.
Did you receive your fitness consultation with a coach?
Yes
No
Was your fitness consultation helpful
Yes
No
What comments or suggestions do you have regarding your fitness consultation?
What feedback or general suggestions or comments do you have to help us improve?
I am providing my 30-day written notice to cancel my membership, as required by my agreement. I understand that I am responsible for any billing including club enhancement that will occur the next 30-days plus the applicable cancellation fee.
Yes
No
I understand that I will still have access to the facility until the date listed below.
*
-
Month
-
Day
Year
Date
Proof of move, medical or other documentation attached
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Date
-
Month
-
Day
Year
Date
Member Signature
Submit
Should be Empty: