Sorry to hear you want to leave us
In order for you to submit your cancellation request please can you complete the below form:
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ACTIVE LIFESTYLE DURSLEY
Section 1 of 2 - Member Contact Details
*1.
First Name
*2.
Last Name
3.
Postcode
*4.
Membership Type
All Inclusive
Couples
Family
Off-Peak
HLS (Healthy Lifestyles)
Student
Swim Only
Be Active (Concession Scheme)
5.
Membership No (if available)
6.
Phone Number
7.
Email Address
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Section 2 of 2
*8.
Why did you join?
Improve Fitness
Improve Health
Weight Management
Health Reasons
Social/Make new friends
Improve skills
Take up a new hobby
Train for an event
Learn a new skill
Other
9.
Do you have any comments about why you joined?
*10.
Did you achieve your goals?
Yes
No
*11.
Reasons for leaving
Unhappy with service
Joining another facility
Not value for money
Having a break/holiday
Facilities
Achieved goals
Moving out of area
Financial reasons
Waiting lists
Availability of class spaces
Consistency of tuition
Medical reasons
Other
12.
Do you have any comments about why you are leaving?
*13.
Would you consider re-joining in the future?
Yes
No
*14.
Would you like to be added to our mailing list for the next 6 months to receive offers?
Yes
No
14.
Please enter your Direct Debit reference below (if known)
This can normally be found on your contract or bank statement.
By clicking submit you are giving permission for us to contact you for the purposes of your enquiry.
Submit
