When you are finished completing the form press 'SUBMIT' and your form will be sent to the front desk staff who will fulfill your request. 

Name *
Please select which Synergy location you attend.
Please select the change would like to make your membership
Choose and complete the appropriate section below; 1. Membership Hold Section 2. Membership Cancellation Section 3. Membership Change
1. Membership Hold Section
Only required if you are requesting a membership hold
Only required for a membership hold
2. Membership Cancellation Section
Only required if you are cancelling your membership
Remember that all month-to-month contacts require 30 days notice for cancellation.
3. Membership Change Section
Chose your new membership option below. If you have questions about memberships or prices please contact us. If you chose Family or Couples memberships we will contact you about who is in your membership.