Edwardsville YMCA Membership Cancellation & Change Form

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We know that life can change in an instant. If you need to make a change to your membership, please fill out this brief form to let us know how you and your family would like to change your membership.
Please make sure you receive a confirmation email after you have filled out this form to, if you have not please fill the form out again. Email will come from "Google Forms".

Email *

Name On Account *

Date Of Birth *

YYYY

Phone Number *

Please Indicate How You Would Like To Change Your Membership *

If Cancelling, Please Indicate The Reason *

Please Provide Any Additional Information To Help Us Assist You With Your Membership Change.

I understand that the Edwardsville YMCA requires a 7 days written notice prior to the draft date (15th) to process changes. *

I understand

Required

Changes To Your Membership

If you are making a change to your membership, we will contact you to make these changes at the provided phone or email.

Thank You For Your Time!

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

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