Withdrawal or Cancellation Request Form

Please view our withdrawal and refund policy here: Programs and Memberships Refund Policy
Name*
First Last
Phone*
Banner ID / Membership Number (if applicable)
Email*
Membership Type or Program (e.g. CU Fit, Hockey Camp…)*
Program start date (If applicable)
Date Format: YYYY dash MM dash DD
Reason for Withdrawal, hold or Cancellation Request*
Please attach any relevant documents related to your withdrawal request (e.g. medical note).
File upload (if applicable)
Max : 2MB
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Note: please check your e-mail and junk-mail folders for a copy of this form for your records