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Consumer Request Web
Form
If you are a California resident and would like to submit a
Consumer Request under the California Consumer Privacy Act (CCPA), please fill
out and submit the below web form.
California residents have the
right to opt-out
of the “Sale” of their personal information. California defines the term “Sale”
broadly to include our selling, renting, releasing, disclosing, disseminating,
making available, transferring or otherwise communicating (collectively a
“Sale”) your personal information to another business or third party for
monetary or other valuable consideration.
For general information about how we handle
personal information of California residents, please see our Privacy
Policy.
Required
fields are marked with an asterisk*. If we require more
information from you, or need clarification about the nature of your request,
we will contact you at the email you indicated below.
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1. * California Residency Are you a California
resident? By clicking yes below, you certify and declare under the penalty of perjury
that you are a resident of California:
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Please confirm relationship to Consumer.
2. * Relationship to Consumer
If you are a parent/guardian submitting a request related to your minor children, please see
sections 15-18 and 20 below for additional information you must provide.
If you are an authorized
agent, please see sections 15-18 and 21 below for additional information you
must provide.
Request Type.
3. * Request Type
If you have multiple requests, please submit a separate form for each request.
4. *Consumer's First Name
5.Consumer's Middle Initial
6. *Consumer's Last Name
7. *Consumer's Email Address
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9. *Consumer's Country
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11. *Consumer's Postal Address
12. *Consumer's City
13. *Consumer's Zip code
Relationship to Orangetheory
14. *Relationship to Orangetheory
15.Requestor’s First Name (only
complete if selected authorized agent or parent/guardian above in #2)
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17.Requestor’s Email Address (only
complete if selected authorized agent or parent/guardian above in #2)
18.Requestor’s Phone Number (only
complete if selected authorized agent or parent/guardian above in #2)
Preferred Method of Response Delivery
19. * Preferred Method of Response Delivery
20. Parents/Guardians
If you are a parent/guardian submitting a CCPA rights request related to your minor
child, please email a written notarized statement under penalty of perjury (and
fraud) that you are the guardian of the minor whose CCPA rights you are seeking to
exercise. If you do NOT provide the signed notarized statement, we cannot honor any
request you submit on behalf of a minor child. After submitting your request through
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The subject line of the email should read as "Parent/Guardian - Notarized Statement -
[Request ID]". The Request ID must be included and will be displayed after this web form
is submitted.
21. Authorized
Agents If you are serving as an
authorized agent for a California consumer, please email a written notarized
authorization form from the consumer that you represent, or a Power of Attorney
document, authorizing you to serve as the consumer's agent for the purposes of
exercising the consumer's rights under the CCPA. If you do NOT provide the signed
authorization, we cannot honor any requests you submit on behalf of a
consumer. After
submitting your request through the webform, please email your notarized statement
attached as a PDF to privacy@orangetheoryfitness.com. The
subject line of the email should read as "Authorized Agent - Notarized Authorization -
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