Membership cancellation form: get a clean request and the reason

Cancellations arrive by phone, email, text and in person. Some never arrive, and then the dispute starts. I would rather give members one clear link with a date on every request. It is a form, not legal advice.

Who it is for

Gyms, studios and clubs that run memberships and want a written trail.

What each question is for

Name, email, membership type and location: so you find the right member fast.
Start date and last day: the dates your billing needs.
Reasons and detail: what you can fix.
Could we keep you: a pause or a different membership may save the member.
Key fob box: a reminder to return access items.
Terms box and typed name: the member confirms the request.

What a member's AI would ask

"What is your name and the email on your membership?" Then "What is the last day you want to be a member?" Then "Why are you leaving?" It shows all answers and sends only after a yes. See agent-fillable forms.

Before you use it

Have a professional check any wording that has legal weight. The form takes no payment details and does not end billing. Browse forms for gyms. A gym membership application opens the relationship, and a workout log can help a member stay.

Questions

Does the form cancel the membership or stop payments?

No. It collects the request only. You check the member against your records and end the membership and any payments in your own billing system.

How do I see why members leave?

Download the CSV and count leaving_reasons by option. Read leaving_detail for the stories behind the counts. Look at could_stay_if to see which saves are realistic.

Is a typed name enough to confirm?

The form pairs a confirmation box with a typed full name. It is not an e-signature service. Check your own terms, and have a professional review the wording.

Or paste the JSON

Give this to your AI. It needs the AI Form API MCP server or an API key. It makes the form and sends you the link.

text

Create this form with the AI Form API create_form tool (or POST https://aiformapi.com/v1/forms with my API key). Then reply with the public_url.

{
  "title": "Request to cancel your membership",
  "description": "We are sorry to see you go. Tell us when you would like to leave and why. Your answers help us improve.",
  "fields": [
    {
      "id": "member_name",
      "label": "Your full name",
      "type": "short_text",
      "required": true,
      "max_length": 150
    },
    {
      "id": "member_email",
      "label": "Email on your membership",
      "type": "email",
      "required": true
    },
    {
      "id": "member_phone",
      "label": "Phone",
      "type": "phone"
    },
    {
      "id": "membership_plan",
      "label": "Your membership type, as on your agreement",
      "type": "short_text",
      "max_length": 150
    },
    {
      "id": "home_location",
      "label": "Which location do you use?",
      "type": "short_text",
      "max_length": 150
    },
    {
      "id": "member_start_date",
      "label": "When did you join, as best you remember?",
      "type": "date"
    },
    {
      "id": "requested_last_day",
      "label": "Last day you would like to be a member",
      "type": "date",
      "required": true,
      "help": "Check your agreement for any notice period."
    },
    {
      "id": "leaving_reasons",
      "label": "Why are you leaving?",
      "type": "multi_choice",
      "required": true,
      "options": [
        "I am moving away",
        "The cost",
        "I do not use it enough",
        "Injury or health",
        "I am switching gyms",
        "Service I was unhappy with",
        "Equipment or cleanliness",
        "My schedule changed",
        "Another reason"
      ],
      "min": 1
    },
    {
      "id": "leaving_detail",
      "label": "Tell us more, if you would like to",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "could_stay_if",
      "label": "Would any of these change your mind?",
      "type": "single_choice",
      "options": [
        "Pausing instead of leaving",
        "A different membership",
        "Fixing the problem I had",
        "Nothing, my mind is made up"
      ]
    },
    {
      "id": "key_fob_returned",
      "label": "I have returned my key fob or access card, or I will",
      "type": "checkbox"
    },
    {
      "id": "terms_understood",
      "label": "I understand my cancellation depends on the terms of my agreement",
      "type": "checkbox",
      "required": true
    },
    {
      "id": "typed_name_signature",
      "label": "Type your full name to confirm this request",
      "type": "short_text",
      "required": true,
      "max_length": 150
    }
  ]
}

Or call the API

bash

curl -X POST https://aiformapi.com/v1/forms \
  -H "Authorization: Bearer $AIFORMAPI_KEY" \
  -H "Content-Type: application/json" \
  -d '{"title":"Request to cancel your membership","description":"We are sorry to see you go. Tell us when you would like to leave and why. Your answers help us improve.","fields":[{"id":"member_name","label":"Your full name","type":"short_text","required":true,"max_length":150},{"id":"member_email","label":"Email on your membership","type":"email","required":true},{"id":"member_phone","label":"Phone","type":"phone"},{"id":"membership_plan","label":"Your membership type, as on your agreement","type":"short_text","max_length":150},{"id":"home_location","label":"Which location do you use?","type":"short_text","max_length":150},{"id":"member_start_date","label":"When did you join, as best you remember?","type":"date"},{"id":"requested_last_day","label":"Last day you would like to be a member","type":"date","required":true,"help":"Check your agreement for any notice period."},{"id":"leaving_reasons","label":"Why are you leaving?","type":"multi_choice","required":true,"options":["I am moving away","The cost","I do not use it enough","Injury or health","I am switching gyms","Service I was unhappy with","Equipment or cleanliness","My schedule changed","Another reason"],"min":1},{"id":"leaving_detail","label":"Tell us more, if you would like to","type":"long_text","max_length":1500},{"id":"could_stay_if","label":"Would any of these change your mind?","type":"single_choice","options":["Pausing instead of leaving","A different membership","Fixing the problem I had","Nothing, my mind is made up"]},{"id":"key_fob_returned","label":"I have returned my key fob or access card, or I will","type":"checkbox"},{"id":"terms_understood","label":"I understand my cancellation depends on the terms of my agreement","type":"checkbox","required":true},{"id":"typed_name_signature","label":"Type your full name to confirm this request","type":"short_text","required":true,"max_length":150}]}'

JSON definition

json

{
  "title": "Request to cancel your membership",
  "description": "We are sorry to see you go. Tell us when you would like to leave and why. Your answers help us improve.",
  "fields": [
    {
      "id": "member_name",
      "label": "Your full name",
      "type": "short_text",
      "required": true,
      "max_length": 150
    },
    {
      "id": "member_email",
      "label": "Email on your membership",
      "type": "email",
      "required": true
    },
    {
      "id": "member_phone",
      "label": "Phone",
      "type": "phone"
    },
    {
      "id": "membership_plan",
      "label": "Your membership type, as on your agreement",
      "type": "short_text",
      "max_length": 150
    },
    {
      "id": "home_location",
      "label": "Which location do you use?",
      "type": "short_text",
      "max_length": 150
    },
    {
      "id": "member_start_date",
      "label": "When did you join, as best you remember?",
      "type": "date"
    },
    {
      "id": "requested_last_day",
      "label": "Last day you would like to be a member",
      "type": "date",
      "required": true,
      "help": "Check your agreement for any notice period."
    },
    {
      "id": "leaving_reasons",
      "label": "Why are you leaving?",
      "type": "multi_choice",
      "required": true,
      "options": [
        "I am moving away",
        "The cost",
        "I do not use it enough",
        "Injury or health",
        "I am switching gyms",
        "Service I was unhappy with",
        "Equipment or cleanliness",
        "My schedule changed",
        "Another reason"
      ],
      "min": 1
    },
    {
      "id": "leaving_detail",
      "label": "Tell us more, if you would like to",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "could_stay_if",
      "label": "Would any of these change your mind?",
      "type": "single_choice",
      "options": [
        "Pausing instead of leaving",
        "A different membership",
        "Fixing the problem I had",
        "Nothing, my mind is made up"
      ]
    },
    {
      "id": "key_fob_returned",
      "label": "I have returned my key fob or access card, or I will",
      "type": "checkbox"
    },
    {
      "id": "terms_understood",
      "label": "I understand my cancellation depends on the terms of my agreement",
      "type": "checkbox",
      "required": true
    },
    {
      "id": "typed_name_signature",
      "label": "Type your full name to confirm this request",
      "type": "short_text",
      "required": true,
      "max_length": 150
    }
  ]
}

A membership cancellation form that is fair to both sides