Cancellation/Freeze

We're Sorry To See You Go

Please complete the form below to submit your cancellation request.

FIRST NAME*

LAST NAME*

EMAIL*

PHONE*

STREET ADDRESS*

CITY*

STATE*

ZIP / POSTAL CODE*

CANCELLATION TYPE*

REASON FOR CANCELLATION*

OTHER — IF APPLICABLE

HOW CAN WE IMPROVE?*

OTHER — IF APPLICABLE

PLEASE SELECT* I understand that if my request is not submitted exactly 30 days from my bill date, I am responsible for the following month’s membership dues. I understand that if my membership is past due, my cancellation request will not be fulfilled. I confirm I am the account holder or authorized on the account and the information provided is accurate. I understand that once I submit this request I will not be able to cancel this request and will be responsible for re-signing on a new contract or membership offered by Gentry Gym.

BIRTH DATE*