Full Name (Member) *

Email *

Phone *

Parent/Guardian Full Name (if applicable)

What's the reason for your cancellation? Please be honest - we truly want to know how we can better meet your needs. *

By marking 'yes', I acknowledge that per Ascension Mixed Martial Arts' membership agreement I must provide a 30-day notice for the cancellation of my membership. I understand that I am accountable for any bills that fall within those 30 days and will continue to have access to the gym and member portals 30 days following the final billing date. Upon submission of this form, one of our staff will contact you for further assistance. *

Yes

By providing your number and information you consent for Ascension MMA to contact you regarding your inquiry via phone calls and/or text messages & email messages. Opt-out anytime by replying STOP. Msg & Data rates may apply.

Signature *

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