Cancellation Form

  • Client Name:

  • Today's Date:

  • Date Format: MM slash DD slash YYYY
  • Reason for Cancellation:

  • Forwarding Address (if applicable):

  • Other Information

  • Type of Disability/Injury/Illness:

    Include proof of disability/injury e.g. doctor’s note.
  • Acknowledgement:​

    I understand that EarthFIT requires 30 days written notice to cancel a training program and that, unless expressly agreed upon by EarthFIT, the termination of my account with EarthFIT will be effective on the date indicated below; and pursuant to my Personal Training/Membership Agreement, I shall be charged a $400 Cancellation fee for terminating a 7 month or 12 month agreement. Although EarthFIT will make every effort to ensure that there are no anomalies with my account, I understand it is my responsibility to ensure that all billing has stopped. I will retain a copy of this Cancellation form as my receipt and contact EarthFIT immediately if billing has not ceased as it was intended.
  • Effective Date of Termination:

  • Date Format: MM slash DD slash YYYY
  • I acknowledge that the information herein is true to the best of my knowledge.
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