First Name *

Last Name *

Email *

Hold Start Date *

Hold Duration *

Reason For Membership Hold *

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I understand that hold requests must be submitted no less than 2 business days before my forthcoming scheduled non-refundable renewal payment. *

Yes

I understand that my non-refundable renewal payment will be processed if this request is submitted less than 2 business days before my renewal date. *

Yes

I understand that if I cancel my membership during the hold period, the 30-day notice required by my membership agreement is still applicable. Any payments that would be scheduled in that 30 day window will be charged. *

Yes

I understand that my membership and non-refundable payments will resume automatically upon expiration of the hold period that I selected above. *

Yes

Additional Comments / Questions *

Signature *

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