Cancellation

Membership Cancellation Form - 30 Day Notice

Your account will be cancelled after the next billing cycle. We will cancel your draft automatically. A copy of this cancellation will be emailed to you for your records.

Member’s Name:
Membership Type:
Address:
City:
State:
Zip:
Phone:
Email:

I am cancelling because:

 Illness Financial Burden Moving Do Not Use Unsatisfied with Programs/Service (please comment) Joined Another Facility Other

Comments:

Please help us improve our service by completing this brief survey:

Cleanliness of Facility:  Excellent Good Average Poor
Friendliness/helpfulness of Front Desk staff:  Excellent Good Average Poor
Friendliness/helpfulness of Wellness staff:  Excellent Good Average Poor
Quality of programs:  Excellent Good Average Poor

 By submitting this form, I am giving BRICK my 30 day written notice to cancel my membership. I understand that my membership will be canceled 30 days from the date this form was submitted. I understand that I will be charged/debited one additional month, for the use of the facility during my 30 day cancellation period. Upon completion of the 30 day cancellation period, my membership shall then be considered terminated. Should I choose to rejoin BRICK after the termination of my membership, I will have to pay at the then current rate.