Full Name
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Email
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How long have you been a member?
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Choose one of the following
0-3 months
3-6 months
6-12 months
1-2 years
2+ years
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Why are you wanting to cancel your membership?
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Select the option that best describes your reason for cancelling
Lack of attendance (I wasn't coming enough)
Relocating (I'm moving to another city/town)
Injury (I am injured)
Location (Not convenient)
Financial reasons (too expensive)
Difficulty (the workouts were too hard)
Maternity/Paternity (I am having a baby!)
Changing up my training (e.g. different gym)
Other (Please explain in the last text box)
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Are you interested in any of these alternative options?
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Please choose one of the following
Downgrade to part-time (to save money whilst also maintaining some accountability)
Move to an online membership
Upgrade to a Personal Training Membership (to increase accountability and support)
Hold your membership for up to 8 weeks
Fully cancel
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What are your goals for the next 12 weeks?
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How well did the coaching staff attend to your fitness goals and needs?
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Extremely well
Very well
Moderately well
Slightly well
Not well at all
How would you rate the gym facilities in terms of equipment, accessibility, cleanliness, etc?
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Incredible (5 stars)
Good (4 stars)
Average (3 stars)
Below Average (2 stars)
Awful (1 star)
How well would you rate your overall satisfaction with our services?
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Incredible (5 stars)
Good (4 stars)
Average (3 stars)
Below Average (2 stars)
Awful (1 star)
How likely are you to recommend us to friends and family?
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Extremely likely
Very likely
Moderately likely
Slightly likely
Not at all likely
Any additional comments, questions or feedback for us?
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Please verify (with initials) that you understand all cancellation requests will take place after the 2 week notice period.
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