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2. Recreation Membership Cancellation Form
   Please complete all required fields.
4. First Name*
5. Last Name*
6. Email*
8. Phone Number*
9. Member ID Number
10. Requested End Date*
    Requested End Date
    Actual end date may vary depending on billing cycle.
12. Membership Location*

    1. MAC
    2. Recreation Center
13. Membership Type*

    1. 3 Month
    2. 6 Month
    3. Annual
    4. Annual with Monthly Payments
14. Reason for leaving*

    1. Moving
    2. Did not use enough
    3. Does not meet my needs
    4. Other

    If other or the facility does not meet your needs, please tell us more below.
16. Please tell us more about why you are leaving.
Leave This Blank:


18. Submit

* indicates a required field