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 6754Mahomet 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 KingUpload 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.