Bronze Membership Cancellation Form

BRONZE PASS CANCELLATION FORM
275 Beasley Drive | Versailles, KY 40383
www.vwcparksrec.com | (859) 873-5948

Requests for cancellations must be submitted at least 15 days prior to the date of draft.
Any request received after 15 days will be processed the next month.

MEMBER INFORMATION

Primary Name of Membership *

First Name Last Name

Address *

Street Address

Street Address Line 2

City

Postal / Zip Code

E-mail *

example@example.com

Cell Phone *

Effective Date of Cancellation

Month Day Year

Reason for Cancelling *

In understand that I can cancel my membership at any time without penalty. If I choose to reactivate my membership within 12 months I will be charged a $25 re-activation fee. I also understand that if I choose to re-actviate my membership after 12 months there will be no re-activation charge.

Signature *

Please Type Name Here *

Date

After completing this form, please click "Submit" below. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam and/or junk folders. If you still did not receive the confirmation email, please contact Rainey Johns at rjohns@vwcparksrec.com.