Request to Change Membership "*" indicates required fields Member Name* Member First Name Member Last Name Phone*Email* Cancellation Policy & Waiver Opportunity: As a reminder, all memberships have a 30-day cancellation policy, which means that upon submitting this cancellation form, you will have 1 more bill date and 30 days to utilize the club thereafter. However, if you’re willing to participate in a brief exit interview, we can waive that final bill! Your feedback is incredibly important to us, and we’d greatly appreciate your thoughts on how we can make the ECA membership experience even better for everyone!*YES, I want to waive my final bill and take the exit interviewNO, I do not want to save $ and take the exit interviewOnce you submit this form: if you selected YES, a Club Coordinator will contact you immediately to schedule your exit interview. If you selected NO, you will be charged one final bill per our cancellation policy. Club Location where I enrolled** Everett Wallingford Columbia City Ballinger Village ECA Membership Type* Champions Amenities Unknown I am requesting to** Cancel my membership Cancellation Reason**Check all that apply. Moving Non-use Too expensive Staff Cleanliness Product Experience Other Other Reason* Notes for Management*I understand that this is a request for cancellation of the above-referenced ECA membership. I understand that I am liable for all payments that are currently due, past due, or those that will accrue during the thirty-day notice period before my cancellation of my membership will be processed. I understand an Emerald City Athletics representative will contact me via the information provided on this form submission to complete the cancellation of my current membership agreement, including the review of last bill date(s), club access availability, and any other questions or concerns I may have. Δ
