Freeze / Cancellation Form Interested in freezing or canceling your membership? Fill out this form and we will be in touch with you shortly to assist with processing your request. Your Name (required) Your Email (required) Phone Number I would like to: Freeze My MembershipCancel My Membership Desired start date of Freeze/Cancellation (YYYY-MM-DD) Freeze Duration: 1 month2 months3 monthsnot applicable - cancelling Reason for Cancelling / Freezing Terms & Conditions Please note that membership freeze and cancellation requests are subject to approval and may incur additional fees as outlined in the membership agreement you signed upon joining. http://empiretriclub.com/membership-agreement/ Click here for more information about our Freeze and Cancellation policy. http://empiretriclub.com/terms-conditions/ If you have a doctor’s note, documentation to support extended travel, or are moving more than 25 miles outside of NYC, please email email@example.com. I have read and agree to the Free Trial Terms & Conditions We have recently experienced some technical difficulties with our freeze / cancellation form. If you do not hear from us within 48 hours, please email firstname.lastname@example.org. Thanks!