Question Title

* 1. Your Personal Information

Question Title

* 2. How long have you been a member?

Question Title

* 3. Why are you terminating your membership?  [Select ALL that apply]

Question Title

* 4. Overall, how satisfied or dissatisfied are you with EB Fitness?

Question Title

* 5. How likely is it that you would recommend us to a friend or colleague?

Not at all likely
Extremely likely

Question Title

* 6. Do you have any other comments, questions, or concerns?

Question Title

* 7. I understand that this request is subject to all the club rules under my membership contract.  

Question Title

* 8. If I Should permanently move my residence more than 25 miles from an affiliated center, payment on this agreement will be suspended upon payment of an appropriate cancellation fee of $50.00 and legitimate certification of the move such as utility bill. I understand that I will be responsible for all payments and fees under the contract.

Question Title

* 9. In case of an open end membership, this will serve as my 30-day written notice that is required under the contract.

T