Membership Cancellation Request On-Line Form

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    Personal (Non-Medical) Reason

    4 to 9 Months remaining in the agreement. Cancellation $499
    10 and up Months remaining in the agreements. Cancellation $999

    Relocation 25+ miles away from the academy

    Multi-Style System or Kickboxing. Cancellation $199.99
    Black Belt Member. Cancellation $ 299.99
    Max file size: 20MB

    Cancelling for medical Reason

    Max file size: 20MB
    Multi-Style System or Kickboxing. 
    I have read the above Agreement, understand and agree with its terms. If the cancellation payment is not remitted, the agreement will be active and the collection company will continue to bill the account. 
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