BIKRAM SOUTHPAS AUTO-PAY MANAGEMENT FORM

Name *
Name
Select Your Current Auto-Pay Plan *
If requesting a hold, please enter the start/end date.
If requesting a hold, please enter the start/end date.
Please note, cost is $20 and can be put on hold for a maximum of 2 months.
End date
End date
If canceling, have you fulfilled the terms of the contract you agreed to?
Please note, per the terms of your contract, there is a 30 day notice required to cancel any auto-pay membership.

Thank you for participating in our membership program!