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Studio Membership Freeze Request Form
This form allows members to send a freeze request to Healing Roots Wellness Center. Please note that per the membership agreement you signed:
A $25 administrative fee will be charged for each freeze request
Freeze requests are only valid for the following membership types: 3 month, 6 month, and 1 year
You may request a membership freeze in monthly increments, for up to 3 calendar months.
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* Indicates required question
Email
*
Your email
What is the name associated with your membership account?
*
Your answer
What membership do you have?
*
3 month
6 month
1 Year
What is the start date for the membership freeze?
*
MM
/
DD
/
YYYY
What is the end date for the membership freeze?
*
MM
/
DD
/
YYYY
Reason for a membership freeze
*
Choose
Injury/sickness/other medical reason
Life circumstances
Weather
Deployment
Other
By sending this freeze request you are permitting Healing Roots Wellness Center LLC the ability to charge the card you have on file the $25 administrative fee associated with freezing your account.
*
I agree
Required
A copy of your responses will be emailed to the address you provided.
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