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The EDGE

Essex/South Burlington - Vermont

SimplePay Membership Cancellation

  • I understand that by cancelling my membership, I am forfeiting the current membership rate that I am paying.
  • I understand that it is my responsibility to contact the EDGE within 30 days if I experience any billing error.
  • I understand that payments already made are not refundable.
  • I understand that this cancellation form is for SimplePay Memberships only.
  • I understand that this cancellation is not considered complete until a confirmation email is received from an EDGE Membership Director.


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Any other participants connected to your membership you wish to cancel.
Reason For Cancellation
Seasonal
Out of Town Move
Medical
Low Usage
Joining a different gym
Other
Cancel My:
Membership
Locker Rental
Master Swim Add-On
Pickleball Add-On
Ultimate EDGE / Tennis Add-On
Wellness Lounge

Requested Cancellation Date (NOTE: Memberships must be cancelled by 1:00pm on the last day of the month to avoid billing on the first day of the next month) . Membership dues are non-refundable after this time due to processing fees incurred. *
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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