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Auto Pay Suspend or Cancel -Upcoming Session
Customer Assignment and Electronic Funds Transfer Authorization for Stars Gymnastics LLC
410 N. Azusa Ave. Covina CA 91722 626-331-8841
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Suspension & Cancellations will begin at the beginning of the upcoming session. Since your child has taken a spot on a class roster in the current session, she needs to finish the session. No cancellations in the middle of a session.
First and Last Name of Student (One form per student)
*
Your answer
Parent's First and Last Name
*
Your answer
Do you want to Temporarily Suspend or Permanently Cancel your Auto Pay account?
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Temporary
Permanently
If Temporary, please list the START & END take of the suspension.
Your answer
Why are you suspending or canceling your Auto Pay?
*
Health/Risk reasons related to Covid-19
Taking a break from the sport
Going on Vacation
Other - Brief explanation below
If you marked "Other", please provide brief explanation.
Your answer
A copy of your responses will be emailed to the address you provided.
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