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2. Please complete all of the information below. Failure to complete all information may result in a delay of your membership being cancelled. If you are moving, please put the address you will be moving to below.
4. First Name*
5. Last Name*
7. Street Number*
8. Street Name*
9. Street Type*
10. Apt #
12. City*
13. State*
14. Zip*
16. Email Address*
17. Phone Number*
19. Please list all names being cancelled.
21. 1)*
22. 5)
24. 2)
25. 6)
27. 3)
28. 7)
30. 4)
31. 8)
33. Reason for Cancellation*

    Please check all that apply

    1. Moving
    2. Changing Gyms

    1. Medical
    2. Cost

    1. Location
    2. COVID-19

    1. Other
35. Membership Type*

    Please select the type of membership you have

    1. Annual
    2. Monthly
36. Payment Method*

    Please select how you paid for your membership

    1. Check/Cash
    2. MasterCard/VISA/Discover
    3. EFT
38. Please note that all check refunds take 3 to 4 weeks to process. Checks will be made out to the main point of contact on the account and mailed to the address listed above.
40. Acknowledgment*

    I understand that by completing this form my membership at the Little Elm Recreation Center will be cancelled.

    1. Yes
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field