Membership Cancellation

Member First Name*

Member Last Name*

Member Email Address*

1. Please select the option below that best describes your reason for leaving.*

2. How well did the Coaching Staff attend to your fitness goals and needs?*

3. How would you describe your satisfaction with the facilities including equipment, parking, and accessibility?*

4. Overall, how would you rate your Rose City Barbell Stength & Conditioning experience?*

5. How likely are you to recommend Rose City Barbell Strength & Conditioning to other athletes?*

Additional Comments/Questions:

I understand that my membership will be canceled from the date this form is submitted.