ORCAS ATHLETICS, BRS, Ltd.
P.O. Box 786 Eastsound, WA 98245
Office: 360.376.6361 Fax: 360.376.6365 www.orcasspaandathletics.com
MEMBERSHIP RESIGNATION REQUEST

I am requesting a termination of my membership to Orcas Athletics. I understand that my membership is cancelable after the contract term has been fulfilled and I have provided 30 days written notice.

I understand that this termination is not effective until:
Orcas Athletics receives the signed and completed Membership Resignation Request Form and contract expiration date is verified.
All membership cards and locker keys are returned.
Any outstanding membership dues or other required payments are made.

I also understand that at date of termination, I will have no further access to the facilities as a member and will not be subject to any further membership dues.

For resignation requests involving moves I also understand that:
Proof of move is required, i.e., a utility bill in my name at my new address, or a rental contract or lease agreement in my name for my new address.
Membership dues will continue to be processed until proof of move is received.
All resignation paperwork must be submitted before the 15th of the month to avoid being charged for the following month.
Refunds are not available for resignations & proof of move submitted after the 15th of the month.

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Signature of Member Date Signed

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Print Name New Address City Zip

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Phone Email Address

Please note: For resignation requests involving special circumstances, please contact the Gym Manager.

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For Office Use Only

[ ] Contract Expiration Verification Completed

Received By __________________________ Date Received _________________________

Notes: