Membership Change Form

Please use the form below to submit changes to your membership or recurring program.

This form is for membership changes and recurring programs like swim lessons, swim team and Masters Swim. If you need to change your child care registration, please use this form.

Please select your YMCA location

Name

Date of Birth

Member ID#

Phone

What change do you need to make?

What program would you like to cancel?

Date of final swim lesson

Recurring Cancellation Agreement

I understand that I must cancel by the 15th of the month to avoid being billed for the following month. If my cancellation is submitted after the 15th of the current month, I understand that my recurring program will continue for one more month and that I will be billed one more time on the 1st of the following month.

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Changing Your Membership or Program

Membership Change Form

Please use the form below to submit changes to your membership or recurring program.