Suspension Form

You understand that by signing below you are suspending your Benefits Program membership. You understand that on the date listed below your automatic payments will resume until you follow proper written procedure to terminate your membership. In honor of your request we will suspend your Benefits Program. During this suspension period you may use your
accumulated sessions as usual, but once all of your sessions have been used you will be considered a non-member and must pay everyday pricing until your suspension is uplifted. You may lift the suspension at any time.