Membership Termination Request Form

Student Name *
Student Name
Parent Name (if student is under 18)
Parent Name (if student is under 18)
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Terms & Conditions *
I acknowledge that my membership will continue through the end of the current billing period for which I am paid. I authorize Revolution Parkour Tualatin to charge my credit card that is on record with Revolution Parkour Tualatin for any outstanding balances, including termination fee, that remain on my account upon the successful termination of my membership.
Notice *
I understand that this is only a request for cancellation of membership and the cancellation date of my membership will be communicated to me upon the successful review of my membership agreement and account by a membership account representative of Revolution Parkour Tualatin. It may take up to 3 business days to review and cancel my membership.