Membership Changes Type of Account Change*FreezeCancellationCancellation Code*Please stop by the club to get the code to process your request. Incorrect attempts will not be viewed.Cancellation*Cancelled Membership w/ 30 Day NoticeCancelled Membership ImmediatelyCancelled Service w/ 30 Day NoticeCancelled Service ImmediatelyFreeze MembershipFreeze ServiceUpgrade/Downgrade ServiceReason for Cancellation*FinancialNo TimeMedicalMoveRewriteOtherAccount Category*MembershipTeam TrainingPersonal TrainingDuration of Freeze*One MonthTwo MonthsFull Name*Email* Agreement Number*Club Location*Beecher 6752Bourbonnais 6793Cedar Lake 6756Champaign 6796Coal City 40030Crete 6754Homer Glen 40036Mahomet 40001Manhattan 6746Manteno 6739Minooka 6794Monee 6742Pontiac 6768Authorized Employee*Tara JuzeszynSam PetersBrian SniderJoshua SchunkeJenna FrommeAlexis KnakeChris TamburichLisa StaskoSarah DenhamTommy MullinsJoe ReganJosh HettigerMike OrwigBrandon RinglerLeanne HefnerJosh BibaBrent BergesonDana OdegaardSamantha GormanAlexis FarrahiRylee SchimmelCheri KruegerHilary BaumannRick KingKyle KesulStephanie MascioUpload doctor's note or deployment papers*Terms of Freeze* I agree to the terms of freeze. Freeze's are approved for medical or military purposes only. Please upload your doctor's note or deployment papers. You may freeze for up to 3 months. If in a term of membership agreement, that term will get extended for the time of the freeze.Terms of Cancellation* I agree to the terms of cancellation. I understand that I am submitting a cancellation request. If my cancellation is approved, my membership cancellation will go into effect 30 days from the next date billing date as stated per my membership agreement. I authorize Fitness Premier to process any fees associated with my account, including any past due balance or final membership dues. I understand that if any of these charges are returned for any reason my membership cancellation request will be voided and the membership will be reinstated. Personal Training/Group Training Requirements If you are attempting to cancel your PT/GT inside of the contract term please note that the membership can only be cancelled due to a permanent medical condition or permanent relocation of at least 25 miles from any facility. Proof is required in the form of either a physician's note on a letterhead, a utility bill, or an official change of address confirmation from the United States Postal Service.Electronic Signature*By typing your name above, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement.