On Hold — CrossFit Pagosa

You may freeze your auto pay ONLY if you cannot perform exercise due to extreme illness, injury or other related health factors OR will be traveling away from home more than 15 miles out of town for more than 1 months time. To freeze your auto pay, a completed request must be submitted via email at least 15 days in advance of your next billing date in order for your request to be effective for the following month. Billing date is based on your activation date. Accounts can be frozen for a maximum of 3 months.

The monthly cost of a frozen account is 15% of your normal monthly fee. The length of the agreement will extend one month for each month the account is frozen.

Name *

Name

First Name

Last Name

Length of Hold *

Reason for Hold *

Effective Date of Hold *

Effective Date of Hold

MM

DD

YYYY

I have read the conditions above and agree that I will be charged 15% of my monthly fee for every month that I hold my membership *

Yes