First Name *

Last Name *

Phone *

Email *

Please select the option below that best describes your reason for leaving.

Reason For Leaving *

Too Expensive (Financial Reasons)

Location (Not convenient or relocating)

Difficulty (The workouts were too difficult)

Injury (I am injured)

Lack of Attendance

Maternity (I am having a baby!)

I am not leaving, just need to change my membership

How well did the coaching staff attend to your fitness goals and needs?

Goals & Needs *

Extremely Well

Very Well

Moderately Well

Slightly Well

Not Well At All

How would you describe your satisfaction with the facilities including equipment, parking, and accessibility?

Satisfaction *

Extremely Satisfied

Very Satisfied

Moderately Satisfied

Slightly Satisfied

Not Satisfied At All

Overall, how would you rate your experience (10 being awesome)?

Experience *

1=Terrible. 10=Awesome

Do you wish to change or cancel your membership?

Cancel or change membership *

How likely are you to recommend us to a friend?

Recommend us? *

Extremely Likely

Very Likely

Moderately Likely

Slightly Likely

Not Likely At All

Membership agreement policy acknowledgement

I agree to the terms of the membership cancellation policy

I am not cancelling, just updating my membership

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