Freeze Request Form

Personal Details

* Required field

* First name

* Last name

* Gender

* Phone Number Add secondary Phone +

Secondary Phone

* Email Address

Add secondary Email +

Secondary Email Address

Date of birth

* Parent/Guardian's name

* Freeze Start Month*

* Freeze Duration*

* Freeze reason*

* Freeze Resume Month*

I understand that this is a 'request to pause' my membership, and will be subject to the facility's pause policy.

Photo

* Required

Capture from camera No camera found. Please connect a camera to use this feature. Upload or use camera Upload photo

Edit Photo

Drag to reposition photo

Zoom

Rotate

Delete Photo Apply

Waiver / liability release

This form is for requesting to freeze a Recurring Monthly Membership. If you are filling out the form for someone else (e.g., a dependent), fill out the name of the person whose account you would like to freeze. In order for us to process a Freeze Request for the upcoming month, this form must be submitted by 11:59pm PST 3 days before the next scheduled billing cycle.

Recurring Monthly Memberships can be frozen for a minimum of 1 month, and a maximum of 2 months. By submitting this form, you acknowledge that you will be automatically re-activated into your Recurring Monthly Membership on the scheduled billing date following the end of your requested Freeze month(s). Forty Five Boxing Pause/Hold Policy: Membership pauses or holds are also subject to a 3 business day written notice submitted to Forty Five Boxing. Members may pause their membership once per calendar year for a minimum of one month and maximum of 2 months, and will still be able to return to their prior member rate. Members whose membership pause lasts longer than 2 months will be charged the most current rate upon their return. Requests for pauses or holds given with less than 3 days notice prior to the next scheduled payment will be charged for one more month with no exceptions.

Done Clear Sign Below:

Signature