Nexus Jiu-Jitsu & MMA ,
Member Request (Pause/Cancel)

Please complete this form if you wish to pause or cancel your membership. We kindly ask that all sections be filled out clearly to ensure smooth processing.

Name *

Email *

Phone Number

Select One Option: *

Pause Membership

Cancel Membership

If Pausing Membership

Pause From (Start Date): *

Pause Until (End Date): *

If Cancelling Membership

Final Payment Date: *

(1 month's notice applies—see policy below)

Your feedback is important to us—please share your reason for pausing or cancelling:

Hold & Cancellation Policy

Membership Pause & Cancellation Policy

to make things clearer and more consistent for everyone.

Here are the key points:

Pause: Up to 3 times per year, max 6 weeks each, $20 fee, 7 days’ notice, form required.
Cancel: 1 month’s notice, $20 fee, form required.

I have read and agree to the Hold Policy & Cancellation Policy Above.

Signature *

Date *