We’re sorry to see you go, but your feedback would be appreciated. Please fill out the survey to help us assess how we’re serving our team.

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Student Name (If a family account, list the primary contact) *

First

Last

Is this form being filled out for more than one member? *

• Yes
• No

Please list your family members who also cancelled their memberships below.

Email *

Phone

How did you enjoy your time at RG Clarksville? *

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Choose 1 - 5 stars, 5 being the best.

How would you rate the class variety? *

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Choose 1 - 5 stars, 5 being the best.

How likely are you to recommend us? *

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Choose 1 - 5 stars, 5 being the best.

How would you rate the class schedule/times? *

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Choose 1 - 5 stars, 5 being the best.

If you rated any of the above questions with less than 5 stars, please share how we could have earned a better rating.

What programs did were you (or your children) enrolled in? *

• Brazilian Jiu-Jitsu
• Judo
• Striking
• Wrestling
• Fitness

What other classes would you like to see us offer?

How would you rate the coaching staff?

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Choose 1 - 5 stars, 5 being the best.

If you rated our coaching staff less than 5 stars, would you please share why and how you feel we can do better?

How would you rate the front desk staff?

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Choose 1 - 5 stars, 5 being the best.

If you rated our front desk staff less than 5 stars, would you please share why and how you feel we can do better?

How would you rate the membership pricing in regards to the value and quality of our classes?

Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5

Choose 1 - 5 stars, 5 being the best.

If you rated our membership pricing in terms of value less than 5 stars, please share your comments.

Any comments, concerns, or criticisms you would like to share?

May we reach out to you about your responses if needed?

• Yes
• No

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