Membership Cancellation Form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required First Name * Last Name * Email * Phone * Cancel membership on: * How long have you been a member at Wreck Room? * 0-6 months6-12 months12+ months How often do you come to Wreck Room? * Irregularly1-2 times a week3-4 times a week5+ times a week Overall, how satisfied were you with the service at Wreck Room? * Below my expectationMet my expectationExceeded my expectation Please indicate the main reason for cancelling your membership: * Moving awaySwitching gymsFinancialNot motivatedMedical reasonsPersonal reasonsUnhappy with serviceOther commitmentsCar parkingOther If 'Other' please specify reason: Would you consider re-joining Wreck Room in the future? YesNo Would you recommend us to your friends? YesNo What could we do to improve the service at Wreck Room? I hereby apply to cancel my gym membership under the Terms and Conditions set out in my membership agreement. I understand that to cancel direct debit memberships I must give 2 weeks written notice and that if I cancel my membership while still under term I will be charged 25% of my contracts remaining membership fees. I also acknowledge that I am authorised to cancel this membership.