MEMBERSHIP CANCELLATION FORM
Street Address Line 2
State / Province
Postal / Zip Code
I would like to CANCEL my membership. I understand the 30-day cancellation policy that I signed when enrolling for the YMCA. I understand that the 30 days starts on the day that the YMCA receives this form, and that my account will be draft one more time before canceling. I understand to re-enroll to the YMCA I might be required to pay enrollment due, have a new membership rate, and fill out all new paperwork.
Cancel my membership (this is my 30 day notice)
Please select the reason you are cancelling your membership:
Could the Y have done anything differently to improve your experience?
Overall, how satisfied were you with your membership?
1=not satisfied at all / 5=exceeded expectations
Should be Empty: