Membership Forms

Quarterly & Annual Memberhship Forms

Membership Hold Request Form

Holds for Memberships are only approved for Military or Medical reasons. Note from Physician required.

Today's Date (mm/dd/yy) (required)

Name (First & Last) (required)

Address (required)

City (required)

Phone (required)

Alternate Phone

Email (required)

What exception to the Membership Policy are you requesting? (required)

Placing a hold on the Membership ( Monthly Memberships excluded)

Extension of the pass

Other

Please explain in detail the reason for your request. Please be specific. (required)

I certify that all the information I have provided on this form is correct.

I agree

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For additonal questions regarding your Quarterly & Annual Membership please email Ruth Brown our Customer Service Manager at r uth@cottonwoodheights.com

Monthly Membership Forms

Membership Cancellation Form

ONLY those who have met the terms of their contract will be approved for cancellation.

Today's Date (required)

Name on Contract (required)

Email (required)

Address (required)

City (required)

Zip (required)

Membership Type (required)

Family

Adult Single

Adult Couple

Senior Single

Senior Couple

Other

Date of 1st EFT Payment (mm/dd/yy) (required)

Current Monthly Payment $ (required)

Type of Withdrawal (required)

Credit Card

Bank

Requested date of final EFT withdrawal (mm/dd/yy) (required)

I understand that all EFT cancellation requests must be turned in at least 15 business days prior to the last payment date bein requested, as stated in my contract. Requests turned in later that 15 business days prior to requested end date are subject to deferment. (required)

I understand

Signature (required)

I agree

Date (mm/dd/yy) (required)

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Membership Change Form

Please fill out all boxes applicable to your needs.

Name on Account (required)

Todays Date (mm/dd/yy) (required)

Phone # (required)

Date of Birth (mm/d/yy) (required)

Update my billing information (for monthly EFT withdrawals)

Select option

Checking Account

Savings Account

Fill out selected billing option information

New Bank Information

Routing #

Account #

Name on account

Bank Name

New Credit Card Information

Credit Card #

Exp. Date

Name on Credit Card

The following information needs to be changed on my account (only type in the boxes that need to be changed)

Address

City

Zip

Email Address

Emergency Contact

Home Phone

Cell Phone

Work Phone

Phone

Membership Changes

Change Membership from a

Single Adult Premium

Single Adult Ultimate

Couple Premium

Couple Ultimate

Family Premium

Family Ultimate

Senior Single Premium

Senior Single Ultimate

Senior Couple Premium

Senior Couple Ultimate

Membership I would like to have

Single Adult Premium

Single Adult Ultimate

Adult Couple Premium

Adult Couple Ultimate

Family Premium

Family Ultimate

Senior Single Premium

Senior Single Ultimate

Senior Couple Premium

Senior Couple Ultimate

Adding or removing person(s)

Add

Name

Birth Date (mm/dd/yy)

Gender

Remove

I would like to remove (list name(s))

I certify that all the information I have provided on this form is correct, and give Cottonwood Heights Recreation Center permission to make these applicable changes to my account (required)

I certify

Today's Date (mm/dd/yy) (required)

Signature *primary account holder (required)

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Thank you, your submission has been received.

For additonal questions regarding your Monthly Membership please email Laura Green our Senior Accounting Specialist at lauragreen@cottonwoodheights.com

Membership Change Form Membership Cancel Form Membership Hold Request Form

Quarterly & Annual Memberhship Forms

Monthly Membership Forms

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