Membership Cancellation Form

• 30 Day notice is required for all membership cancellations

• Please keep a copy of this cancellation for your records

Membership Number: __ Membership Type: ______________

Member’s Name:

Address:

City: State: Zip:

Phone: Email: _________________________________________

I am canceling because:
____ Illness
____ Financial burden
____ Moving
____ Do not use
Unsatisfied with programs/service (please comment)
____ Joined another facility
____ Other (please explain below)

Explain:

Please help us improve our service by completing this brief survey:

Excellent Good Average Poor

Cleanliness of Facility 4 3 2 1

Friendliness/Helpfulness of staff 4 3 2 1

Quality of the classes 4 3 2 1

Would you recommend UFC Gym to your friends or family members? Yes No

I understand that I will be charged one month beyond the date of this cancellation form. I have a 30
day window to rejoin without having to pay an enrollment fee. I understand that I may continue to
use the facility until the cancel date.

___________________________ _________________
Member Signature Date

________________________________________ _________________________
Staff Signature Effective Date