Membership Suspension Form

Membership Suspension Form

MOMENTUM FITNESS WARRNAMBOOL
Please read this carefully before submitting!

You do not have to take your membership off suspension as it will be automatically reactivated. If you want to reactivate your membership earlier, simply attend Momentum Fitness and inform reception that you wish to reactivate your membership. We will process it on the spot and you can resume using the facility staright away.

If you wish to extend your suspension simply fill out another suspension form for the extended period.

As the suspension is reactivated automatically from the date supplied by you, it is your responsibility to inform us if you need to extend the suspension period.

If you have either a 3yr or 12month Lockin Membership, please be aware that suspending your membership will add the suspension time to your lockin period.

Fillout all of the details below and then hit Submit, once we receive the form your suspension will be activated staight away (during Staffed hours).

*Please be aware that Suspending your membership will incurr a $5.00 fee per week until your membership is restarted.
Membership Number if Known:
Optional
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*
example@example.com
Reason for Suspension*
If other, please explain
Start Suspension Date*

DayMonthYear
Date
Membership Commencement Date*

DayMonthYear
Date
Signature

Clear
Should be Empty: