Rec Center Payroll Deduction Membership Cancellation Form

First and Last Name:

Email:

Phone Number:

Would you like to cancel your Annual Student Recreation Center Membership?:

Yes, I want to cancel my annual Student Recreation Center Membership.

No, I do not want to cancel my annual Student Recreation Center Membership.

Fee Acknowledgement:

I understand there is a $60 early-cancellation fee.

Cancellation Reason:

Additional comments:

Updated: 10/30/2026 09:43PM