Name

First Name

Last Name

Phone

(###)

###

####

Your Request

Current Membership

Please select the membership type you currently have

Start Date of Pause

The date you would like to start the pause

YYYY

Date to Resume membership

Pleases provide the date for your membership to automatically resume.

YYYY

Optional Survey

Reason for Pause

Notes

Please leave a message regarding your request, such as the dates of your pause, why you would like to cancel your membership or delete your account.

Checkbox

By checking this box, I certify that I am the person submitting this request and that all information provided is true and accurate. I understand that my membership will automatically resume on the “Date to Resume Membership” I select, including the reactivation of any associated autopayments, and that I am responsible for all payments once my membership resumes. I acknowledge that pause requests are not guaranteed and may be approved, denied, or ended at the sole discretion of Embody Through LLC, which may reinstate my membership and resume billing at any time. I further understand that all memberships, products, services, and related contracts are non-refundable. By checking this box, I authorize Embody Through LLC to process this pause request in accordance with these terms.

I Agree

Your request has been submitted and will be executed in the system shortly.

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Pauses Your Membership

Embody Through LLC