Consent to Transfer Membership from Another Club

Member First Name*

Member Last Name*

Email Address*

Phone Number*

Street Address*

Street Address Line 2

Postal / Zip Code*

City*

State / Province*

Country*

New Home Club Location*

I agree

I give my authorization to Anytime Fitness operated by SITE2GYM to transfer my membership to their club.

I understand that my membership dues may change depending upon new club membership dues.

New Address Proof

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