Cancellation Form

First Name

Last Name

Address 1

City

Postal Code

Home Phone

Mobile

Email Address

Student #1 Name

Student #1 Date Of Birth

Student #2 Name

Student #2 Date Of Birth

Student #3 Name

Student #3 Date Of Birth

Lesson Day
(select all that apply)

Lesson Time
(select all that apply)

Morning

Afternoon

Evening

Reason for cancelling
(select all that apply)

If you selected "other" above, please fill in here:

Date Of Last Lesson (must give 30-day notice)

Jr.FIT Cancellation Form