You must cancel 30 days prior to last auto-draft of membership.
(must cancel at 3 month mark for 4 month memberships,
11 month mark for 12 month memberships;
30 days notice for M2M)
$250 early termination fee applies
Member Name (required)
Your E-Mail Address (required)
Cancel Request Date (required)
Cancel Effective Date (required)
Reason for Cancellation
Last Payment Amount (required)
Cancellation Fee (required)
CashCheckCCTo Be BilledEFT/CC
Payment Date (required)
Total Amount Paid (required)
If this amount is not paid within 10 days of the above date, I authorize 5 Points Yoga to continue billing the agreement as originally scheduled.
To help us service our members please complete the following:
Did you use our studio often?
Did you see an improvement in your practice?
Do you feel you achieved your fitness goals?
Are you healthier than when you started?
Are you going to continue your practice outside our facility?