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CHILDREN'S SUCCESS SEMINAR
Membership Freeze Request On-Line Form
Membership Freeze policy:
A member has the option to put the membership in hold or freeze for a maximum of 90 days and one time per year.
You may not retroactively freeze your membership. Until the billing company will process this form your membership will be in active status (Aloud five business days). Your membership will be automatically re-activated when you are re-attending class and scan your card in the system.
Indicates required field
Reason of holding
Personal (Non-Medical) Reason
Please give me credit in the end of the agreement. The payment will continue to be deducted from the account normally but a Credit may be used to extend the membership for the same number of months the account will be in hold.
I am holding the account for medical reason. Full membership rate will not be charged during your freezing period. I agree to extend the agreement for the same number of months I’m putting in hold. I understand I need to provide a specific medical certificate proving the impossibility to attend martial arts classes before the account will be on hold. To keep the account active
I understand I’ll be charged a monthly freeze fee of only $15
on the EFT date and I will not receive membership benefits. Once the membership reaches the unfreeze date the account will be re-activated at regular membership rate. In the event the membership must refreeze in the same year, one EFT must process before a secondary freeze is granted.
Upload Medical Certificate Here
Max file size: 20MB
I have read the above Agreement, understand and agree with its terms. I further understand that the failure to attend lessons during the freezing period does not relieve the obligation to pay the remaining installments and tuition balance in full.
Hold the account for
Member Signature (or guardian under 18)
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