Gym Cancellation Form

Cancellation Form
We are sad to see you go but we thank you for being a part of Ettalong Diggers Gym & Swim. If there is any way we can help you continue your fitness lifestyle, let us know! Do you know that if for any reason you need a break or are unable to use the facility for a certain period of time, you can put your membership on hold for up to 3 months per calendar year free of charge?

If you really do wish to cancel your membership, please fill out the sections below:
Full Name*

PrefixFirst NameLast Name
Date of Birth*

DayMonthYear
Day-Month-Year
Phone Number*

Area CodePhone Number
E-mail*
Why do you wish to cancel?*

Moving out of the areaMedical reasonsFinancial reasonsHaven't achieved the results you wantedUnhappy with the equipment at the facilityOther
What were your goals when you first joined Ettalong Diggers Gym & Swim?
Have you achieved that goal?

YesSort ofNo
What could we have done to help you achieve it?*
If your membership has gone beyond its contracted period and there are no outstanding amounts on the account, it will be cancelled within 30 days (as stated in your membership contract agreement) from the date we receive this form. You are liable for any membership payments that occur in that time and you must pay the cancellation fee if you have not fulfilled the minimum term on your contract. If for any reason your membership cannot be cancelled, we will contact you within 7 days. Please ensure all contact details are correct.
I have acknowledged the above notes*

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Signature
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