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Change Form

Date: July 5, 2025

First Customers Name
First Name*
Last Name*
Phone*
First Customers Date of Birth*
Date of Birth
First Customers Signature*
Second Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Third Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Fourth Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Fifth Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Sixth Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Seventh Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Eighth Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Ninth Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Tenth Customers Name
First Name*
Last Name*
Customers Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
CHANGE FORM: Upgrades, Downgrades, Freezing or Cancelling Services - all profile changes will begin the SAME day of submission!
I would like to:*
Freeze
Cancel
Change (upgrade, downgrade or unfreeze EFT)

FOR CANCELLATION CLIENTS: Please understand if you do NOT return your key fob within 5 business days from the day you submit this form, you are agreeing to pay the $15.99 non-returned key fob fee with the card we have on file.





Cancellation Start Date (same day of waiver submission) :

Reason for Cancellation:

FOR FREEZE CLIENTS: Please understand that you are only able to unfreeze your account ONCE within the current year before a $19.99 fee is applied. ALL FROZEN ACCOUNTS REMAIN IN OUR SYSTEM FOR ONLY 2 YEARS BEFORE ACCOUNT DELETION!









Freeze Start Date (same day of waiver submission) :

Reason for Freezing:

FOR UPGRADE/DOWNGRADE/UNFREEZING CLIENTS:






Payment Due Date:
New Payment Amount:

Notes For Staff:
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*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
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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