Fort Hill Fitness Membership Freeze

Memberships may be frozen one time in a 12 month period for a minimum of one month and a maximum of four months. If you are on a debit plan, your normal monthly payments will be stopped for the length of your freeze. If you are paid in full, your membership expiration will be extended the same length as your freeze. There is no cost to freeze your membership and you can reactivate your membership before your freeze ends.

Requests to freeze Fort Hill memberships must be received by the 10^th of the month in order to stop the next payment from being processed. Requests received after the 10^th will result in the member being charged for the next scheduled payment and the freeze taking affect the following month.

Prime, Renew Active or Silver Sneakers members should contact their benefit provider for freeze information.

THIS IS NOT A CANCELLATION FORM

Member Requesting Freeze: *

Last Name * 🛈

Date * +

Phone Number * 🛈

Email *

Enter names of all additional family members - not including yourself - to be put on freeze:

	First Name	Last Name
1.	First Name	Last Name
2.	First Name	Last Name
3.	First Name	Last Name
4.	First Name	Last Name
5.	First Name	Last Name
6.	First Name	Last Name

Are you freezing a family membership: * 🛈

Are you requesting to freeze a Childcare membership *

Enter First and Last Names of Child(ren) *

Please choose the length of freeze. Freeze requests received prior to the 10th of the month will begin on the next scheduled payment date. For example, if a 4 month freeze request is received on Dec. 1st the Dec. 15th payment would not be processed and the next payment would be on April 15th. *

Reason for freeze *

Medical

Traveling/Returning to School

Not Utilizing

Other Other

I agree if all fitness members in my family have not been listed on the freeze request that any remaining active memberships will continue to be charged the appropriate amount with the existing payment plan information. I also understand that my payment plan will resume automatically when the freeze has expired.
If I have paid in full the membership expiration date will be adjusted accordingly.
*

I agree

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