First Name:

Last Name:

Street Address:

City:

Zip Code:

Phone Number:

Reason for cancellation?

I understand that if I cancel and choose to rejoin the Y after 30 days have passed, I will need to rejoin as a new member and pay the corresponding joining fees.

I understand that to avoid having an additional bank draft drawn, I must cancel my membership by the 8th of the month. It is my responsbility to verify that the cancellation was succesful. I understand that the YMCA is not responsible for reimbursing membership fees for more than 2 months after my date of cancellation.

I understand that I have the option to put my membership on hold for up to 3 consecutive months in a calendar year. To do this, I must complete a form and pay a administration fee of $25.00 at the Welcome Center.

Comments / Questions: