MEMBERSHIP HOLD

    Holding is for people who may not be able to train for 2 months or more but still want to come back to their current special. Holding includes the Online University at no additional cost for Adult Members.
    **IMPORTANT! YOU WILL RECEIVE A CONFIRMATION EMAIL AFTER THE PROCESS IS COMPLETE. IF YOU DO NOT RECEIVE AN EMAIL, YOU DID NOT SUBMIT THE FORM CORRECTLY.**

    Read more about holding your account here.

    Students Name (First, Last): (required)

    Account Holder's Name. *Who is Paying*
    (First, Last): (required)

    Your Email: (required)

    **You will receive a confirmation email.**

    Why are you holding your account?

    Account you wish to use for payment:

    Type of Account:
    Name on Account:
    Last 4 Digits of Account/Card Number:

    I UNDERSTAND (required):

    1. This constitutes as my 31 days written notice for hold and my payments will change ($25 /mo.) AFTER the next billing cycle ([next-month], [this-year]) per the agreement I signed. I understand and agree that the account above will continue to be charged the hold amount for subsequent months per the signed agreement of 31 days written notice. The $25 per month will include the Online University and also hold the rate I pay and class schedule I take at CPAMMA when I am ready to return after the minimum 2 months for hold. If I want to come back before the minimum two months hold I will charged the remainder of my monthly rate for the 1st month on hold and the remainder for the 2nd month I was supposed to be on hold.

    **HOLDS MUST BE FOR A MINIMUM OF TWO FULL MONTHS**

    2. I need to keep a copy of the confirmation email sent after I submit this form. If I don't receive a confirmation email I will resubmit this form until I have received the confirmation. However, if I am still having trouble I will need to email info@payment-company.com to notify The Payment Company to receive additional instructions on submitting the online form. The confirmation email is my proof of my hold request and I understand that until I have submitted it successfully, I have not put my account on hold. Putting my account on hold is not completed until the HOLDING STUDENT has a copy of the cancellation. Secure copies are kept on the server and time/date stamped.

    3. I understand that even if I didn't use my membership that I am not eligible for any type of refund, per the agreement I signed. I also understand that if I cancel while I am on "hold" I will still be charged the $25 for the minimum two months. If I choose I can reinstate my membership during the first month I will have a $25 hold credit to go towards my monthly payment. If I choose to reinstate my membership during the second hold month I will still be charged the $25 hold fee.

    4. By checking the following box I understand and agree to the Membership Policies and have read the FAQ regarding our rules, payments, cancellations, holds, etc.

    5. I agree and confirm that I am 18 years or older and if I am not the student who this notice is concerning, I confirm that I am the parent or legal guardian of the above student.

    I UNDERSTAND AND AGREE TO ALL OF THE ABOVE:

    If you are holding due to injury, please submit your doctor's note. **Note must include how long you are not allowed to do (insert program here) to be valid.**:

    Please type in the letters below:
    captcha

    Then click "Send" below: