Freeze RequestPlease complete the form below to freeze your membership. Name * First Name Last Name Email * Phone * (###) ### #### Is there anyone else connected to your membership you'd like to freeze? List their name(s) Reason for freeze: * How many months would you like to freeze? * One Month Two Months Three Months What month would you like your freeze to start? * TERMS OF FREEZE * • You may freeze up to 3 months within a 12 month period at 1/3 cost of your current membership dues. • For each month you are frozen, you'll be charged 1/3 of your dues (Ex: $45/month will be $15/month freeze fee). • Memberships can only be frozen on the billing date. • Requests must be submitted 5 business days prior to your billing date. • During a freeze month, you may access the club a maximum of three times. After the fourth visit, you will be charged 100% of dues for that month. • The amount of month(s) your membership is frozen will extend the overall length of the agreement but will not change the term quantity. • The annual enhancement fee will be charged regardless of a freeze. • Upon completion of the freeze, the payments will be due without prior notification. If your membership agreement is set up on auto pay, the payments will be drafted automatically. • This freeze request applies to membership only and does not include any unused services, such as personal training, Pilates, or team training packages. • Exemptions available for medical and military reasons. Documentation required. Email to memberservices@212fitnessclub.com • If your membership is cancelled during a freeze, the last month, within the 30 days notice, will be charged at full membership dues. By checking this box, this serves as my signature in agreement to the freeze terms. Thank you!
