New member sign-up with joining agreement, PAR-Q+ health screening with liability waiver, group class registration, day pass and guest visit form, plus member feedback and cancellation request — for boutique studios running CrossFit, yoga, pilates, HIIT, and small-group strength classes
Get started with PocperUse this single combined form to (a) leave feedback or suggestions, (b) request a freeze or pause of your membership for a defined period, or (c) submit a formal cancellation. We respond within 3 business days. Honest feedback helps us improve and is welcomed even from cancelling members — please tell us what worked and what didn't.
Full name:
Member ID:
Membership type:
Join date:
Email:
Mobile:
Tick everything that applies — you can combine feedback with a freeze or cancellation request.
Feedback only (continuing as a member)
Request to freeze / pause membership
Cancellation request
Switch to a different membership tier
Compliment / shout-out (a coach, the front desk, etc.)
Complaint / concern needing follow-up
Overall how would you rate your experience?
Excellent
Good
Average
Below average
Poor
How likely are you to recommend us to a friend?
Very likely
Likely
Neutral
Unlikely
Very unlikely
What's working well for you?
What could we improve?
Coach or staff member you'd like to call out:
Freeze start date:
Freeze end date:
Total days requested:
Reason (medical, travel, work, financial, other):
Freeze acknowledgments:
I understand a freeze pauses billing but extends my commitment by the freeze duration.
I understand a freeze of more than 30 days requires manager approval and may incur a small admin fee.
I will provide supporting documentation (e.g. medical note) if requested.
Last day of membership requested:
Reason for cancelling:
Why are you cancelling? (tick everything that applies)
Moving away
Cost / financial reasons
Schedule no longer works
Injury or health issue
Found a different studio
Not getting the results I wanted
Coach / class quality issue
Facility / cleanliness issue
Customer-service issue
Other (please describe below)
Anything else we should know about why you're leaving? (Honest feedback helps us improve.)
Cancellation policy acknowledgments:
I have read and understand the cancellation notice period in my agreement.
I confirm any minimum-commitment period has been satisfied (or I accept the early-termination fee).
I understand my final billing date is calculated based on the notice period.
I would like to be contacted about coming back if a special offer becomes available (optional).
Currently on:
Wish to switch to:
Effective from:
Reason for the switch:
Anything else you'd like to share with the team?
I confirm the information above is accurate.
I understand the studio will respond within 3 business days.
(Cancelling only) I authorise the studio to process my final billing date as described.
Member signature:
Date:
Studio staff received by:
Date received:
Manager approval (if required):
Date:
Thank you — whether you're sticking around, taking a break, or moving on, we appreciate you taking the time to tell us why.
The Member Feedback & Cancellation Request template is a ready-to-use form from Pocper's Boutique Fitness Studio pack. Customize the fields to match your workflow, then share a link so clients can complete it and upload documents in real time.