Membership Freeze Request
Member Name
*
Last Name
Email
*
example@example.com
Date Freeze to Commence
*
-
Month
-
Day
Year
Date
What would you like frozen?
*
Membership
Training
Both
How many months would you like to freeze?
*
1
2
Why would you like to freeze?
*
Please explain
Medical Note Provided
*
Yes
No
Will you be travelling during the freeze?
*
Yes
No
If yes, where are you travelling too?
Please explain
I understand that i will not have access to the my local Anytime or any of the 4500 Anytime Fitness’ worldwide while travelling.
*
Yes
I understand that without a doctors note, I will be responsible for a $10 per month or $5 bi-weekly processing fee during freeze and that billing will commence as usual upon the freeze expiring.
*
Yes
I understand that I will still be responsible for club enhancement charged in October and April of each year, while my account is frozen
*
Yes
I understand that my account must be in good standing to qualify for a freeze
*
Yes
I understand that if I wish to resume my gym activities early before expiry of the freeze, I must notify the Anytime Fitness Staff to my account can be unfrozen.
*
Yes
I understand that if I wish to cancel during of after my freeze the regular cancellation policies will apply.
*
Yes
File attached (such as medical proof)
Browse Files
Cancel
of
Member Signature
Submit
Should be Empty: