Aquatic Center Membership Cancellation Form Please enable JavaScript in your browser to complete this form.Member Name *FirstLastMember Key Tag Number *Phone Number *Email *Membership Type *IndividualFamily of 4MyParkMyPark Plus+Hold or Cancel Membership *HoldCancelPlease list any additional members on the account that wish to cancel/hold below *Reason for Cancellation/Hold *Lack of UseMoving Out of TownMedical ConcernJoined Another GymSeparation from WVUEnrolled in ClassesNo Longer Afford MembershipOther (please specify)Other *Write N/A if you selected a different option listed above.Please check each box to acknowledge that you have read and members has agreed to each of the cancellation terms *I understand that the cancellation/hold form must be submitted in writing to Mylan Park 5 days prior to the month in which I wish to cancel.I understand that if the cancellation/hold form is submitted after the deadline I will be billed for the following month and my membership will end at the end of that month.I understand my cancellation/hold will not be processed unless I have a zero balance on my account.I understand that my key tags must be turned in to Mylan Park on my last day of my membership.I understand that if I signed up for an annual membership, I cannot freeze, cancel or get a refund for my membership (unless a medical reason).I understand that if I am the main member on the account, that if I cancel my membership, my spouse and/or dependents memberships will end as well.Please type name of member to acknowledge all terms and proceed with cancelling their membership *FirstLastToday's Date / Time *DateTimeProcessed By (Staff Member) *Submit
