Membership Changes Type of Account Change*UpgradeFreezeDowngradeCancellationCancellation Code*Please stop by the club to get the code to process your request. Incorrect attempts will not be viewed.Cancellation Request*Canceled Membership w/ 30 Day NoticeCanceled Membership ImmediatelyCanceled Service w/ 30 Day NoticeCanceled Service ImmediatelyFreeze Request*Freeze MembershipFreeze ServiceFreeze Length*1 Month Freeze2 Month Freeze3 Month FreezeReason for cancel?*Not seeing resultsFinancialTimeMoveOtherAuthorized Employee*Tara JuzeszynDaniele ChristianRidge WarrenMolly OConnorChristopher EvansJoshua JamesChris TamburchLisa StaskoSara GeorgeTom ReidyJoe ReganKrynn PalugaMike OrwigLeanne HefnerRebecca Martin-BerryJosh BibaDana OdegaardSamantha GormanTaylor MooreCheri KrugerMolly HallKyle KnezeticPhillip CoprichChange Notes* Email* Full Name*Agreement #*Membership Type*MembershipPersonal TrainingGroup TrainingTanningClub Location*Beecher 6752Bourbonnais 6793Champaign 6796Crete 6754Lowell 6756Manhattan 6746Manteno 6739Minooka 6794Monee 6742Pontiac 6768Streator 6776Did member return MyZone band?*Upload doctor's note or deployment papers*Terms of Downgrade* I agree to the terms of downgrade. We are more than happy to downgrade your current membership for you there will be a $49 downgrade fee and if you are downgrading to an Express of Basic membership you will also be in a 12 month term agreement. We will charge your account on file the $49 at the time of downgrading your membership and you will receive an email confirmation as well.Terms of Upgrade* I agree to the terms of upgrade. There is no charge for an upgrade. If in a term of membership agreement, that term's current length will remain.Terms of Freeze* I agree to the terms of freeze. Freeze's are approved for medical or military purposes only. Please upload your doctor's note or deployment papers. You may freeze for up to 3 months. If in a term of membership agreement, that term will get extended for the time of the freeze.Terms of Cancellation* I agree to the terms of cancellation. I understand that I am submitting a cancellation request. If my cancellation is approved, my membership cancellation will go into effect 30 days from the next date billing date as stated per my membership agreement. I authorize Fitness Premier to process any fees associated with my account, including any past due balance or final membership dues. I understand that if any of these charges are returned for any reason my membership cancellation request will be voided and the membership will be reinstated. Personal Training/Group Training Requirements If you are attempting to cancel your PT/GT inside of the contract term please note that the membership can only be cancelled due to a permanent medical condition or permanent relocation of at least 25 miles from any facility. Proof is required in the form of either a physician's note on a letterhead, a utility bill, or an official change of address confirmation from the United States Postal Service.Electronic Signature*By typing your name above, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement.