Request to Change Membership "*" indicates required fields Member Name* Member First Name Member Last Name Phone*Email* Club Location where I enrolled** Everett Wallingford Columbia City Ballinger Village I am requesting to** Downgrade Membership Freeze my membership Cancel my membership Cancellation/Freeze Reason**Check all that apply. Moving Non-use Too expensive Staff Cleanliness Product Experience Other Other Reason* Notes for Management*On a scale of 1-10 (10 being excellent), please rate the following:Facility*Facility12345678910Staff*Staff12345678910Classes/Services*Classes/Services12345678910Overall Experience*Overall Experience12345678910Knowing what I know now, would I rejoin ECA? Why or why not?*I understand that this is a request for cancellation/freeze 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/freeze 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/freeze 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
