Name *

First Name

Last Name

Phone *

(###)

###

####

Hold Start Date *

Request must be submitted at least one (1) week before hold start date.

MM

DD

YYYY

Hold End Date *

The hold period is a minimum of 4 weeks.

MM

DD

YYYY

Hold Policies *

-Memberships may be placed on Hold for a minimum of 4 weeks. -Members may have a ‘free’ 1 month (4 wk) Hold in a calendar year. After the first free 4 weeks, any additional weeks will be a $5/week Hold fee. -On the same Hold, additional weeks will be prorated at $5/week. -Holds will be billed to the payment method on file. -Any additional Holds in the same calendar year will be $20 for the first 4 weeks and $5/week after.

I agree to the above terms.