Membership Cancellation Form

Please use this form to submit a cancellation request for your month-to-month membership.

First Name*

Invalid Input

Last Name*

Invalid Input

Address*

Invalid Input

Address 2

Invalid Input

City*

Invalid Input

State*

Invalid Input

Zip Code*

Invalid Input

Email*

Invalid Input

Phone*

Invalid Input

Other Phone

Invalid Input

I request that my month-to-month membership be cancelled. I understand it will be cancelled 30 days from today’s date, per the membership agreement. I understand that my final monthly payment will be pro-rated based on the cancellation effective date indicated below.

*

I Agree Invalid Input

Select Membership to Cancel:
Memberships in this household not listed below will remain active. In the event the Primary Member of this household is being cancelled, a Secondary Member will be transferred to Primary Member status.

Choose one of the following:

*

Cancel all memberships on this account, OR

Only cancel the memberships listed below:

Invalid Input

Member Name

Invalid Input

Member Name

Invalid Input

Member Name

Invalid Input

Reason for Leaving*

Other Reason for Leaving

Invalid Input

What did you enjoy most about your membership?

Invalid Input

What can we do to improve the member experience?

Invalid Input

I have requested the above change to my fitness membership and give permission to the City of Eagan to change my form of payment and/or the amount of payment as needed to fulfill my request.

*

I Agree Invalid Input

Membership Cancellation Form

City Hall

City Jobs

Connect

Contact Us