Membership Changes - Fitness Premier Clubs

Type of Account Change*

Type of Freeze*

Type of Cancellation*

Reason for Freeze*

Reason for Cancellation*

Notes

Duration of Freeze*

Full Name*

Email*

Agreement Number or Barcode (can be found in the FP app)*

Club Location*

Upload doctor's note or deployment papers*

Max. file size: 50 MB.

Terms of Freeze*

I agree to the terms of freeze.

I understand that I am submitting a freeze request. If my freeze request is approved, my account will be placed on hold for the amount of time requested. My recurring payment will automatically continue after the length of the requested freeze term. If my Annual Maintenance Payment is scheduled during the freeze term, I will be billed for that payment. If my membership is a term membership the frozen months will be added to the end of the term.

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 cancellation will go into effect 30 days from the next billing date as stated per my month to month agreement. If my agreement is in a term, my cancellation will be set to process at the end of the term as stated per my term agreement. I authorize Fitness Premier to process any fees associated with my account, including any past due balance, final membership dues, or final service dues. I understand that if any of these charges are returned for any reason my cancellation request will be voided and the membership will be reinstated.

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.