Live Active

Complete this form to allow us to freeze your membership. Please note the membership freeze will take a few working days to be applied.

First Name(*)

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Surname(*)

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Date of Birth(*)

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Please put your Date of Birth in DD/MM/YY format.

Postcode(*)

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Email Address(*)

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Contact Number(*)

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Start Date(*)

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Please put start date for freezing your membership in DD/MM/YY format.

Reason for the freeze(*)

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Duration

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When is your payment date?

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Confirmation(*)

Please tick this box to confirm you have agreed to Live Active Leisure freezing your Annual or Direct Debit membership. Invalid Input

Data Protection: The information provided by you, about you on this form, will only be used for the purposes of freezing your membership. We are committed to complying with the General Data Protection Regulation and the Data Protection Act 2018. For further information on how we process personal data, please see our privacy policy available on our website.

Freeze Membership Request