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Membership Cancellation Request

First Name *

Last Name *

Phone *

Email *

Are you cancelling yourself or your child? *

Me

My Child

Which location are you cancelling? *

Select the option that best describes your reason for leaving. *

How would you describe your satisfaction with the coaching you received from us? *

How clean were the facilities? *

How satisfied were you with your overall experience? *

Would you recommend us to your friends? *

Additional Comments/Questions

I understand that this is a request to cancel and that the gym's has a 4 week cancellation policy which will be activated from my next payment *

Yes

PROGRAMS

Reformer Pilates

12 Haydock St, Forrestdale

WA 6112

Unit 7/5 Milford St, East Victoria Park

WA 6101