Membership Holds & Cancellations

Legal Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Email

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Change Requested *

Membership Hold
Membership Cancellation

Membership Hold

As an accommodation to our members, the YMCA has made provisions for memberships to be placed on hold. *

You acknowledge the following:

Holds take effect at the beginning of the next draft cycle with 7 days’ notice.

Holds are for 30, 60 and 90 days per year.

Membership dues automatically return to original draft amount beginning the month you’ve indicated below. The start date is determined by your original draft date.

Month to Begin Hold *

Month to Resume Membership *

Membership Cancellation

What was your primary reason for joining the YMCA of Big Spring? *

If we could have done one thing to keep you as a member, what would that have been? *

Which statement below best describes your primary reason for cancelling your membership? *

Other: *

Overall how would you rate your experience with the YMCA? *

Excellent
Good
Fair
Poor

Would you consider re-joining the YMCA of Big Spring? *

Yes
No

Signature *

Clear Signature

I hereby request that my membership at the YMCA of Big Spring be discontinued or placed on leave of absence as indicated above. I understand that I must give 7 days’ notice prior to my membership draw date in order to make any changes to my automatic withdraw including cancellation. Failure to do so will make subsequent drafts nonrefundable. Your signature also acknowledges your understanding of the provisions above.

Email *

Membership Holds & Cancellations

We require a 7-day notice prior to draft date to cancel.

You are responsible to ensure the cancellation/or Hold has occurred.

Request Hold or Cancellation

Membership Hold

Membership Cancellation