Request A Freeze Of Services Order Number Member Information Date * MM/DD/YYYY Member Name * Name as it appears on Membership Agreement Scanner Card Number * Scanner Card Number Used to Check-In at Club Family Member(s) Changes will apply to all parties on a family membership Billing Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Primary Phone Alternate Phone Number Email * **Freeze period must be in 30 day increments and must start and end on your draft date.** Membership time may be frozen for a maximum of 90 days total. If your membership is still In Term, Payments Will Continue As Scheduled During The Frozen Period. The frozen time will be given back immediately after your expiration date. If your membership is Month to Month, please contact us by email on the Home Page of this website regarding eligibility to freeze your draft. Delinquent accounts cannot be frozen. Freeze From Date * MM/DD/YYYY Freeze To Date * MM/DD/YYYY Please indicate if you have more than one service you are requesting to be frozen. **A MINIMUM OF FIVE BUSINESS DAYS NOTICE IS REQUIRED FOR ANY CHANGES TO TAKE EFFECT** BEFORE SUBMITTING: Please review the information above for accuracy. National Fitness is not liable for any fees that you incur due to the reporting of inaccurate information.