Leave of Absence Request

Subject: Medical Leave of Absence Request

Hi,

We completely understand that your health and wellbeing come first. If you need to take time away from your membership for medical reasons, we’re here to support you every step of the way.

To help us process your request smoothly, please review and complete the information below. Once received, we’ll finalize your medical leave of absence accordingly.

Please note that a minimum of one full calendar month’s notice is required for all membership changes. If your request is submitted outside of this timeframe, your membership end date will be automatically adjusted to meet this requirement.

We appreciate your understanding and wish you the very best in your recovery and wellbeing.

Primary Member Name:

Primary Member Number:

Current Membership Dues:

Monthly LOA Membership Dues:

Leave of Absence Requested Start Date:

Leave of Absence Requested End Date:

Please review and acknowledge that you’ve read and understand the following policies:

I acknowledge and agree to pay any remaining balances before the start of my Leave of Absence.

I agree to the monthly LOA dues amount of $.

I agree that no one listed on this membership account will use a Bay Club facility during the time period my membership is on LOA and if a facility is used, my LOA will be canceled, and I will be responsible for the full month’s dues amount.

I agree that unless cancelled, locker rentals and laundry service are charged at the full prevailing rate during LOA.

I agree that one calendar month’s notice is required to extend my LOA.

I agree and understand that all of the provisions contained in the Club’s current Membership Agreement, including those under the Membership, Categories of Membership, and General Terms and Conditions sections (including minimum club hours of operation), now apply to my membership. I also acknowledge that the Club may vary these provisions from time to time at its sole discretion without notification.

I agree that I have read and understand the terms and conditions of the Membership Agreement and this addendum, and I agree to be bound by the provisions contained therein.

There is no limit to the number of times a member is permitted to go on LOA. However, in order to request an additional LOA, you must return to active membership status for a minimum of 1 month. In addition, LOA cannot be applied retroactively

i changed my mind

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