Wheaton Sport Center

Membership Cancellation Request

Date:
Member Name:
Membership Number:
Home Phone:
Cell/Work Phone:
E-mail:

I wish to terminate my membership with Wheaton Sport Center. I understand that I am responsible for any and all charges acquired through the next 30 days while my cancellation is processed.

Please note:
Membership will cancel 30 days from the date the form is filled out.

Reason for cancellation:

Moving

Joined Another Club, if so which:

Financial Reasons:

Club not meeting expectations:

Not using:

Other (please explain below)

If moving, please state new address:

Address:

City: State: Zip:

Home Phone: Work/Cell Phone:

Return all membership cards on your last visit to the club.

Please type your name and date this will serve as your signature and
agreement to the above document.

Member Name: Date: