Withdrawal Request Form

Please complete the Withdraw and Cancellation Request Form to cancel or request a refund.

Online membership cancellation requests

Please view our withdrawal and refund policy here: Programs and Memberships Refund Policy

Name(Required)

First Last

Phone(Required)

Banner ID / Membership Number (if applicable)

Email(Required)

Membership Type or Program (e.g. CU Fit, Hockey Camp…)(Required)

Program start date (If applicable)

Reason for Withdrawal, hold or Cancellation Request(Required)

Please attach any relevant documents related to your withdrawal request (e.g. medical note).

File upload (if applicable)

Max. file size: 2 MB.

Max : 2MB

CAPTCHA

Note: please check your e-mail and junk-mail folders for a copy of this form for your records