Name *

First Name

Last Name

Phone *

(###)

###

####

Membership Type *

Membership Details - 3 x Sessions per Week Unlimited Sessions Junior Muaythai Unlimited - 4 week cancellation notice required. - 2 week suspension minimum. - 8 week suspension per year maximum. 10 Session Pass - 3 Month Expiry. - 2 week minimum pause. - 4 week maximum pause. Which membership are you on?

3 x Sessions per Week

Unlimited Sessions

10 Session Pass

Junior Muaythai Unlimited

Date suspension to commence. *

When would you like to hold your membership? If cancelling, put today's date.

MM

DD

YYYY

Date suspension will end. *

When would you like to return? If cancelling, put final date. (Must be 4 weeks from today's date.)

MM

DD

YYYY