Name:

Phone Number:

---

Freeze Policy

• Only one freeze is allowed every 12 months
• The single freeze permitted per year must be between (1) and a maximum of (3) months and must be done in 30 day increments. Only one freeze is permitted per year regardless of hold length. IE if you freeze your membership for one month, you may not freeze it again at a later date for any length of time until 12 months has passed.
• No retroactive freezes

Enter Your Initials To Acknowledge You have read and agree to the Freeze Policy

---

Type of Hold?
Standard Hold $25/monthMedical Hold $0 (Must provide doctor's note)

Please explain the reason for your membership freeze.

Length of Hold:
1 Month2 Months3 Months

Do you have an Unlimited Kids Club that you would like to freeze as well? Yes (please provide name below)No

Kids Club Member Name(s)

This form will only freeze the contract of the member listed above. If there are multiple people attached to this account, each person must complete their own freeze form.

I understand that at the end of the freeze duration listed above my membership will automatically reinstate and bill. (Enter your initials to agree.)

I understand that freezing my membership simply puts a "pause" on my membership and I am still responsible for all monthly or annual payments and dues outlined in my original contract. (Enter your initials to agree.)

Enter Your Name as Your Electronic Signature:

Today's Date:

Your Email: