55 Temple Place 2nd Floor
Boston, MA 02111
(617) 820-5195

Membership Hold Form

Not A Termination Request

Form must be submitted at least 5 business days before next draft date for changes to be effective for that draft date.







I understand that my draft will automatically restart after my hold period.:
I understand that Holds for less than one (1) month are not available:
I understand that I may place my account on hold only one (1) time per calendar year, for up to three (3) consecutive months:
I understand that a twenty percent (20%) hold fee will apply for each billing period, or prorated period, that my account is on hold:
I understand that my hold cannot be applied retroactively and I must allow at least 5 days for the hold to be applied to my account:
I understand that if I cancel during the Hold Period, I must submit a separate Cancellation form and it will be subject to the Cancellation Policy per my Membership Agreement:

Membership Cancellation Form - 30 Day Notice

Your account will be cancelled after the next billing cycle. We will cancel your draft automatically. A copy of this cancellation will be emailed to you for your records.






State:




I am canceling because:


Cleanliness Of Facility:

Friendliness/helpfulness of Front Desk staff:

Friendliness/helpfulness of Wellness staff:

Quality of programs:

By submitting this form, I am giving BRICK my 30 day written notice to cancel my membership. I understand that my membership will be canceled 30 days from the date this form was submitted. I understand that I will be charged/debited one additional month, for the use of the facility during my 30 day cancellation period. Upon completion of the 30 day cancellation period, my membership shall then be considered terminated. Should I choose to rejoin BRICK after the termination of my membership, I will have to pay at the then current rate: