Membership Cancellation Request

WE’RE SORRY TO SEE YOU GO

If you decide to reactivate your membership in the future (and we hope you do), membership rates in effect at the time of reactivation will be applicable as membership rates are subject to change.
If you’re confident you would like to cancel your membership, complete and submit the form below.
This will serve as your written 30-day cancellation notice as your membership agreement requires.
Note that if you have a scheduled payment within these 30 days, the payment will be processed as scheduled. All payments are non-refundable.

Cancellation Notification Date

IMPORTANT: This is NOT your cancellation date. This is your notification to cancel date. Your membership will only be cancelled 30 days after your notification date.

First name

Last name

1. Please select the option below that best describes your reason for leaving.

2. How well did our coaching Staff attend to your fitness goals and needs?

3.How would you describes your satisfaction with the facility, including equipment, parking and accessibility.

Overall, How would you rate your CrossFit Kimba experience?

How likely are you to recommend CrossFit Kimba to friends and family?

Additional Comments & Questions?

Your feedback is important to us. Please provide additional information or feedback to help us improve our services.

I understand that my membership will only be cancelled 30 days after the notification date

I understand that according to my membership agreement any scheduled membership payment within my 30 day notice period will be billed as normal.

I understand membership payments are NOT refundable. I shall remain liable for declined or late payments including the late payment penalty fees

Your Signature

Signature field is empty.

By signing this form I accept the above outlined terms and conditions.