NAME
*
First Name
Last Name
PHONE
*
(###)
###
####
EMAIL
*
DATE OF BIRTH
*
MM
DD
YYYY
WHO/WHAT ARE WE CANCELLING?
*
Please list names of all members on your account you would like to cancel, as well as any services (such as child care or locker rental) you wish to cancel. Any members or services NOT listed will NOT be cancelled, and will continue to be charged to the payment method on file as scheduled.
IMPORTANT: CANCELLATIONS WITHIN CONTRACT TERMS
*
Members who have not fulfilled their full contractual agreement (example: 12 payments on a standard agreement), will be contacted and notified of their final payment date, billing will continue as scheduled, and this cancellation notice will be considered a pre-cancellation for the end of their contract terms once all payments are completed in full.
If you are still within contract with. more than two payments remaining, we do offer our members a "buy-out" opportunity at half the remaining balance on your contract (example: 5 months left in contract would be billed at a one time payment of 2.5 months of dues). Buy-outs are effective immediately, payment is due at time of buy out, and your gym access will cease immediately upon buy-out. Please contact the club if you wish to take advantage of a membership buy-out.
30 DAYS NOTICE REQUIRED
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Per my signed contractual agreement and posted signage, I understand that I am submitting my 30 days' notice to cancel my membership and will accrue one final payment on my next scheduled bill date.
NOTICE OF PAST DUE BALANCES
*
I understand that my Elite Performance LLC account must be current without a past due balance, and I may have one more payment due on my account. I understand that if I fail to pay for any past due balance or final payment, that I may be liable for additional rejection fees, late fees, and ultimately sent to collections and will accrue collections costs.
AUTHORIZED MEMBERS TO SUBMIT CANCEL REQUEST
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I understand that only members that are listed and linked for billing purposes on your account, AND at least 18 years of age, may submit cancellation for the account. If you are not link to another member for billing purposes, you are not authorized to cancel their account for them.
FINAL BILL DATE
*
Should you submit this notice on the same date as your billing date, you acknowledge that today's payment will serve as your final bill. No further charges will be applied to your account, and your membership will remain active until the end of the current billing cycle.
ADDITIONAL MEMBERS AFFECTED
*
I understand that I am responsible for listing all members affected by this cancellation notice, and any members on my account not listed, will continue to be billed as scheduled.
USE OF FACILITY
*
After your cancellation notice is submitted and final payment is received, no further charges will be applied to your account; your membership and access will remain active until the end of the final billing cycle that you have paid for.
REFUNDS AND CREDITS
*
No refunds or prorated credits will be issued for the remaining days of use within your final billing period. Should a technical error occur, and your bill continue after final payment, member has a personal obligation to notify Elite Performance LLC within 60 days of the first error charge, for a refund full refund on dues. A maximum two billing periods will be refunded to the member in the case of an error and ongoing billing.
QUESTIONS, COMMENTS, CONCERNS? LET US KNOW.
Ask away...
Thank you! A member of our management team will respond to this request via email to confirm your cancellation and your final bill date.
Staff will also follow up with you via email and phone if there are oustanding issues preventing cancellation of your account (past due balance or within contract).
IF YOU DO NOT RECEIVE CONFIRMATION, it is member responsibility to please follow up with us to confirm submission was received. Technical issues happen!
A copy of this form will be sent to your email.
