Name (required)
Email (required)
Phone (required)
Zest Card Number (required)
Centre (required) Culm Valley Sports CentreExe Valley Leisure CentreLords Meadow Leisure Centre
Requested Date of Cancellation (required)
Reason (required) Can't afford the membershipNot enough time to exerciseNot motivatedInjury/IllnessNo longer wants swimming lessonsMoving awayOther (please state below)
Other Reason
