Account Cancellation Request This is a 30 day notice to cancel your LifeQuest account. Request will be processed within 5 business days. Name Email Message What type of account are you cancelling? Individual Couple Family (3-4 people) Family Plus (5+ people) Senior Individual Senior Couple Do you have a rented locker? Yes No If so, what is your locker number? EARLY TERMINATION POLICY ACKNOWLEDGEMENTI understand that if I request to cancel my account plan within the first 4 months of my account activation date, I will be assess a $99 cancellation fee. This cancellation fee will be automatically charged upon receipt of this request. The billing cycle is defined as a monthly dues payment. The dues payment is not the enrollment fee. For example: You join LifeQuest on May 1. You pay $10 enrollment fee and $0 dues. Unfortunately life happens, you need to cancel your plan on June 5, 2024. A $99 cancellation fee will be assessed before your cancellation can be honored. Yes No My account plan falls outside the early termination policy What email address can we send your cancellation confirmation? Signature Date Send