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Who we are
Meet the team
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Muay Thai
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Muay Thai
BJJ & Wrestling
Strength & Fitness
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Muay Thai
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Cancellation Request
YEWS
2024-05-10T02:14:51+10:00
Cancellation Request
Apply to cancel your Direct Debit membership
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Name
Member’s first name
Member’s last name
Email
Phone
Reason for cancellation
Your honest feedback is important to us as it provides us with opportunities to improve or to suggest alternatives to cancellation which may suit you.
Current Membership Status
If you are unsure, please contact Admin on 9568 4999 or email admin@extrememma.com.au to check your current status.
Select
I am still within my minimum term (I have not completed the minimum number of fortnightly payments within my membership term)
I am outside my minimum term (I have completed the minimum number of fortnightly payments within my membership term)
Terms of Cancellation (Within Minimum Term)
Please tick the boxes below to indicate your understanding and acceptance of these terms:
Term #1
I understand that my membership will be cancelled only at the end of my minimum term, meaning that my fortnightly direct debits will continue to run until the minimum number of payments have been completed. I will still have access to the gym and classes during this time.
Term #2
I understand that I am able to transfer the remaining fortnights in my minimum term membership to another person who is not currently a member of Extreme MMA. It is my responsibility to contact Admin to provide details required to organise the transfer. I understand that my fortnightly direct debits will only be cancelled once the transfer has been successfully completed.
Term #3
I understand that any outstanding arrears on my account must be settled before my application for membership cancellation or transfer will be approved.
Term #4
I understand that my registration with Extreme MMA will lapse after my membership cancellation date, and that a registration fee may be payable if I choose to re-start my membership in the future.
Term #5
I understand that submitting this form is only a request for cancellation, and that Admin will contact me within 3 business days if my application contains errors, if my account is currently in arrears, or if further clarification is required. My membership cancellation will only be processed once my application has been approved.
Terms of Cancellation (Outside Minimum Term)
Please tick the boxes below to indicate your understanding and acceptance of these terms:
Term #1
I understand that I am required to give two fortnights’ notice of active membership to cancel as per my membership agreement, during which time I will still have access to the gym and classes.
Term #2
I understand that any outstanding arrears on my account must be settled before my application for membership cancellation will be approved.
Term #3
I understand that if my application is approved, my fortnightly direct debit will be cancelled after two successful debits from the date this form is submitted.
Term #4
I understand that my registration with Extreme MMA will lapse after my membership cancellation date, and that a registration fee may be payable if I choose to re-start my membership in the future.
Term #5
I understand that submitting this form is only a request for cancellation, and that Admin will contact me within 3 business days if my application contains errors, if my account is currently in arrears, or if further clarification is required. My membership cancellation will only be processed once my application has been approved.
Have you found an alternative physical activity to continue your fitness journey with?
Yes
Not yet, but I plan to
No
Would you consider returning to training at Extreme MMA in the future?
Yes
Maybe
No
Would you like us to check in with you down the track?
Yes – 1 month from now
Yes – 3 months from now
Yes – 6 months from now
Not right now, but I’ll contact you when I’m ready
Parent’s name
If cancelling on behalf of your child
Signature
Phone
This field is for validation purposes and should be left unchanged.
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