Free cancellation letter 27
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MEMBERSHIP CANCELLATION REQUEST FORM
Note: All Cancellation requests must be reviewed and approved by a fitness manager before becoming effective
Powerhouse Gym Chatsworth Cancellation Policy:
A member may cancel their membership at any time after the initial commencement date by notifying Powerhouse Gym in
writing by mailing through the United States Mail, first-class, certified-return receipt requested, a thirty (30) day prior
written notice to the address listed below. If member has a Type III contract member understands that they may not
cancel their membership during the initial term unless one of the following has occurred and written proof has been
submitted: 1. The member has permanently relocated further than 25-miles from the facility and we are unable to transfer
your membership contract; or 2. A medical physician certifies that the member is unable to permanently engage in
physical exercise.

SECTION 1: TO BE COMPLETED BY MEMBER
Today’s Date:_____________________Member Name