PASSHOLDER TERMINATION REQUEST ACKNOWLEDGEMENT
Date of Request:
Club Account Number:
Name of Passholder:
By signing this termination request, I respectfully request that my deposit be returned to me and I relinquish my Passholder rights for Summer 2020. I also acknowledge that all deposits will be mailed to me within 6-8 weeks of the inspection (club employee and Passholder in attendance for inspection) pursuant to a satisfactory and cleaned out accommodation.
Fax to: Silver Gull 718.634.6300 Surf Club 718.634.6700
E-mail to: firstname.lastname@example.org