Membership Cancellation Form Name * First Name Last Name Email * Please list the email connected to your BW Studio account. Phone * (###) ### #### I am requesting the cancellation of my auto pay Monthly Unlimited Membership, Class Pass (4,8,12) or Online Auto Renew Membership. My notice is effective the date this form is delivered to Hello@BarreWest.com. I agree that my Monthly Unlimited Membership, Class Pass or Online Membership has met its minimum payment terms as outlined in the membership agreement. * Agree I understand that a cancellation request requires 30 days notice for all Auto Renew Memberships. * Agree I would like my cancellation date to be: * *Effective date must be a minimum of 30 days from today for Monthly Unlimited Members. 10 Pass Auto Renew Members must submit minimum 72 hours prior to auto renewal date. I am cancelling my membership due to: * E.G.: Injury, Travel, Financial, Not Using Enough I understand my final account payment may be charged at a pro-rated amount for the remaining monthly obligation should renewal payment fall within the 30-notice period. * Example: Cancellation request received: April 1st Scheduled Monthly Payment: April 15th (Pay Pro Rated Rate for 15 days (50% of monthly payment)) Cancellation Effective Date: April 30th Agree Thank you! Your Membership Cancellation Request has been submitted to hello@barrewest.com. A member of our team will be in touch via email to confirm your cancellation activation within 5-7 business days. Please reach out to hello@barrewest.com if your cancellation request has not been confirmed within 7 business days.