Full Name:

Email:

Phone Number :

Membership Number or Scan Tag #:

Facility Location:
West LA/Santa Monica

Reason for Freeze Request (Select one below):
---FinancialMedical ReasonsTravelWork ScheduleSeasonal (Snowbird)Summer Time/Outdoor WorkoutsOther

Length of freeze Requested (Select one below):
---1 Month2 Months3 Months

More Information:

TERMS & CONDITIONS

A freeze is effective upon the next billing date in increments of one month and for a maximum of three (3) months per twelve (12) month period. I acknowledge that billing is temporarily postponed during the length of the freeze only. If the freeze should be cancelled within the freeze period, the entire monthly dues will be billed in full.

As an Annual or Term Member, I acknowledge that I am responsible for the remainder of the membership fees under the Member Agreement regardless of the length of freeze. All terms of the Agreement continue in full force and effect, including the member’s payment obligations.

Freezes cannot be initiated retroactively. 7 days’ written notice prior to billing date is required for all freezes. To request a freeze, I must (1) submit this electronic form to The Gym L.A. at least 7 days before the requested freeze is to begin and (2) be current on all dues, fees and other charges against account.

Upon completion of the freeze period, my membership will be automatically reinstated. I authorize The Gym L.A to resume billing of my membership using the credit card on file. Following a freeze period, my term membership expiration date will be extended by the total amount of days that my membership was frozen.

If an Annual or Term Membership is cancelled during the freeze period. The full remaining balance on the agreement is immediately due. I authorize The Gym L.A to charge my credit card on file for the full balance.

I acknowledge that the above information is accurate and correct. Any misrepresentations with the current information are the sole responsibility of the undersigned. Furthermore, I understand that the freezing of my membership will be executed as per the terms and time frame outlined in my membership agreement. I understand that certain membership types are subject to increases in initiation fees, membership dues, freeze fees, etc.

Lastly, I authorize The Gym LA to charge my credit card that is on file with The Gym L.A. for any outstanding balances that remain on my account upon the successful freezing of my membership. Failure to do so will result in an automatic reinstatement of monthly membership dues for the remainder of the Membership Agreement.

By checking the Terms and Conditions box and clicking the Submit button on this page, I, acknowledge that in order to freeze an Annual or Term Membership, I am obligated to complete this form and provide The Gym L.A, upon request, with documentation supporting the freeze request.

Full Name:

Email:

Phone Number:

Membership Number or Scan Tag #:

Facility Location:
West LA/Santa Monica

Reason for Cancellation Request (Select one below):
---FinancialMedical ReasonsJoined Another GymDissatisfactionNon-UseWork ScheduleBuilt Home GymMoved5 Day Guarantee

More Information

30 DAY CANCELLATION NOTICE: *

By checking the Terms and Conditions box and clicking the Submit button on this page, I understand that I authorize the processing of my membership at The Gym L.A. I acknowledge that the above information is accurate and correct. Any misrepresentation with the current information are the sole responsibility of the undersigned. Furthermore, I understand that the cancellation of my membership will be executed as per the terms and time frame outlined in my membership agreement. I understand that returning members are subject to increases in initiation fees, membership dues, freeze fees, etc. I authorize The Gym, L.A. to charge my credit card that is on file with The Gym L.A. for any outstanding balances that remain on my account upon the successful cancellation of my membership.

I understand that this is only a request for cancellation of membership and the cancellation date of my membership will be communicated to me upon the successful review of my membership agreement and account by a membership account representative of The Gym L.A.

By checking this box and clicking the Submit button below, I acknowledge that the cancellation request can take up to 30 (thirty) days to be processed. I further acknowledge that if my next scheduled billing date is less than 30 days from the submission date of this form, I will be billed as per the terms outlined in my contract.

Name *

Preferred Date *

Preferred Time *

Membership Type *
---Month-to-MonthAnnual1 Month1 WeekOther

Phone Number *

Your Email *