Membership on Hold form

Student's First Name (if you have more than one child please separate the names with commas)

Student's Last Name

Name of Person Submitting the Form - Please leave blank if you are submitting the form for yourself

Email Address

Phone Number

Date of First class missed

Date of First class back (please note on holds must be for 2 or more weeks, absences of 1 week instead a make up lesson will be automatically added to your profile and you do not need to fill in this form)