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Membership Freeze Form

To request a freeze on your membership, this form must be completed and submitted at least 10 days prior to your next billing date. A$10 freeze fee a month will be charged during the duration of the freeze. Memberships may be frozen for a maximum of 3 months per calendar year. All membership freezes must start and end on either the 1st or the 15th of the month.

If a membership is reactivated on the 1st or the 15th of the month and billing has already occurred, a pro-rated charge will be applied for the remaining portion of the billing cycle.

*Freezes are a minimum of 1 month and a maximum of 3 months*

Only the Membership's Group Leader can fill out and sign forms.
I acknowledge that I am the Head Account Holder for this membership*
Yes
Freeze From (Month)
Month*
Day*
Until (Month)
Month*
Day*
Member Information
Address *
City *
State *
Zip *
First Member Name
First Name*
Last Name*
Phone*
First Member Age Acknowledgment*
First Member Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Member Signature*
Second Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Third Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Fourth Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Fifth Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Sixth Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Seventh Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Eighth Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Ninth Member Name
First Name*
Last Name*
Member Date of Birth*
Date of Birth
Tenth Member Name
First Name*
Last Name*
Member 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.
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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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