Cancellation Request Form Terms & Conditions to Process Cancellation: A request to cancel a membership will be reviewed by a manager to determine if all terms to cancel a membership have been met. You will be contacted by email with any final payment amounts owed and the last day of your membership. A request to cancel must be completed by the paying member on the agreement, unless a minor. In accordance with the membership agreement, the member must provide a minimum number of days notice and be in good standing. An account currently frozen or in past due status cannot be canceled. I will be billed as per the terms outlined in my agreement for all dues and/or fees owed on my account, to successfully cancel my membership. My information on this form is accurate and correct. Any misrepresentations with the current information is the sole responsibility of the undersigned. The cancellation of my membership will be executed as per the terms and time frame outlined in my membership agreement. Femme will charge my credit card that is on file and collect any upcoming dues and/or fees, within the cancellation time frame, as early as today to successfully cancel my membership. If I wish to re-enroll, I will be enrolling as a new member and subject to the current membership rates and terms. Member Signature: Date:
