Name *

First Name

Last Name

Cancellation Date Request *

Please ensure the date is 14 business days before your next billing cycle for changes to be effective before that draft date.

MM

DD

YYYY

Checkbox *

By checking these boxes you understand the following:

You may cancel your membership at any time after the paid commitment period indicated by the package you selected, by giving the IronGrip thirty (30) days advance written notice. You will remain liable for payment of dues and other charges for periods prior to the effective date of cancellation. If you cancel during your paid commitment period, you will remain responsible for paying dues for the remaining commitment period. Until you provide written notice of cancellation as stated above and make all outstanding payments, you will continue to be charged monthly dues.

By submitting this form, I am giving IRONGRIP JIU JITSU my fourteen (14) day written notice. I understand that my account will be canceled 14 days from the date this form was submitted. I understand that I will be charged/debited one additional month if this form is not submitted 14 days before my billing date in which case my cancellation date will be at the end of that period. Should I choose to rejoin Irongrip Jiu Jitsu after the termination of my membership, I will have to pay at the then current rate.