Rent A Gym - Equipment Rental Application

Please use the following pick up notification form to notify rentagym.com when you are ready for us to pick up your fitness equipment. Once we receive notification, a representative from rentagym.com will contact you to confirm and to schedule your pick up.*

* You are required to notify us at least 5 days prior to your next payment's due date or your monthly
rental charge may be applied.

Equipment "Pick Up" Notification

Which type of fitness equipment are you returning?
(check all that apply)

	Treadmill
	Elliptical
	Exercise Bike
	Weight Bench
	Home Gym

	Other (Please Specify)

Please complete as much information as possible.
* indicates minimum required information.

First Name*

Last Name*

Best Phone *

best number to contact you

Alternate Phone

Address 1

Address 2

City*

State *

Zip Code

Email Address*

Comments

Security Code*

To prevent spammers from abusing our form, please enter the security code shown into the box above, all UPPERCASE. Thank you.

home fitness equipment, exercise machines, treadmills, ellipticals, exercise bikes, home gyms, fitness accessories, etc.