Athletic Facility Cleaning Refusal Form
Please complete this form to formally decline or refuse scheduled cleaning services at your athletic facility. Your acknowledgment helps us maintain accurate records and understand your facility’s needs.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Facility Name or ID
*
Date of Cleaning Service Being Refused
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Scope of Cleaning Being Refused (select all that apply)
*
Locker Rooms
Restrooms
Gymnasium
Fitness Equipment Areas
Offices/Common Areas
Other
Reason for Refusal
*
Please Select
Facility Closed
Cleaning Not Needed at This Time
Event Scheduling Conflict
Maintenance/Construction Ongoing
Other (please specify below)
If you selected 'Other' above or would like to provide more details, please explain:
Alternative Instructions or Requests (optional)
I acknowledge that refusing cleaning services may impact facility cleanliness, safety, and operations. I confirm this refusal is intentional and understand potential consequences.
*
I acknowledge and confirm
Signature (draw your signature below)
*
Submit Refusal
Submit Refusal
Should be Empty: