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Freeze or cancel membership request

TERMS & CONDITIONS:

  • If you freeze your EFT monthly membership, $9/month* (+txs) fees will be charged on your credit card the 10 of every month. Allez UP will cancel the membership if two consecutive payments are declined on the credit card.
  • When you reactivate your EFT monthly membership, you will have to pay the prorated amount of the remaining days until the next automatic payment(10th day of the month).
  • If you freeze a pre-paid membership, $9/month* fees will be charged when you re-activate your membership.
  • If you cancel your EFT monthly membership, your membership will still be valid until the next 9th day of the month.
  • A "one month prepaid" membership cannot be freezed. Membership must be more than one month to be eligible for freezing.


* One month is equal to 31 days. For exemple, if you freeze your membership for 32 days, you will be charged two fees of $9/month.

I read and accept the terms and conditions.

Signature:


Date: April 26, 2024

First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Options
Request*
I would like to freeze my membership.
I would like to cancel my membership.

Reason *
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*

Relationship*
Parent or Guardian's Date of Birth*
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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