Membership Termination Form

YMCA of the Twin Tiers - Membership Cancellation Form

Bradford, Olean, and Wellsville
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
What is your reason for cancelling your membership?*
Signature
Here at the YMCA of the Twin Tiers, we value your membership and the satisfaction of your experience is of the utmost importance.

Kindly let us know how we are doing by answering this brief survey. It will take approximately 3 minutes. Your feedback is important for us to know, so we can see what we are doing well and what we can be doing better to meet your needs.
1. Did you utilize your 3 free introductory wellness consultations?

YesNo
2. Were there any areas of the YMCA or programs specifically that you enjoyed?

Aquatics Center (pool areas) *Childwatch (KidZone)Group Exercise Classes (in studio or pool)Gymnasium (basketball courts, pickleball courts)Locker RoomsRacquetball Court *Indoor Track *Wellness Center (weight and cardio room)Other
3. Were there any areas of the YMCA or programs in the facility you think we could improve upon?

Aquatics Center (pool areas) *Childwatch (KidZone)Group Exercise Classes (in studio or pool)Gymnasium (basketball courts, pickleball courts)Locker RoomsRacquetball Court *Indoor Track *Wellness Center (weight and cardio room)Other
4. What caused you to join initially?
5. How likely are you to return?

Very LikelyLikelyNeutralUnlikelyVery Unlikely
6. What would have made your membership more beneficial?
7. What would encourage you to re-join?
8. Would you recommend us to friends and colleagues?

YesNoRather Not Say
Should be Empty:

YMCA of the Twin Tiers - Membership Cancellation Form