Membership Cancellation Form

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Monthly membership drafts continue until the member notifies the Y they wish to terminate the membership. Membership is not dependent upon usage. Member is responsible for making any changes to membership.

THE CANCELLATION NOTICE MUST BE RECEIVED AT LEAST 30 DAYS PRIOR TO THE DRAFT DATE IN ORDER TO CANCEL THAT MONTH'S DRAFT.

Note: All membership payments are for membership in the month the draft was drawn.

I request the YMCA to terminate my authorization to draw preauthorized bank drafts for membership payment.

Email *

Members First and Last Name *

Members Street Address *

Members Phone Number *

I would like to: *

Cancel my membership

Required

Reason why I am canceling my membership *

A copy of your responses will be emailed to the address you provided.

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