Member Request Form

Member First Name

Member Last Name *

Email *

Phone *

Request *

Select an option

Put a membership ON HOLD
Take a membership OFF HOLD
CANCEL a membership
REMOVE an add-on
Other (Please fill out comment section)
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Start Date for Request *

End Date (Membership Holds Only)

*The Minimum Hold Time for All Eligible Memberships is 14 Days

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Submitting this form DOES NOT complete your request. You will receive an email/text confirmation that your request has been completed within 48-72 hours of submitting this form. Please contact the facility with any questions you may have

(706) 201-4713 / info@keppnerboxingathens.com

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