Contact Name Email Phone Birthdate:* Home YMCA Facility: Membership Reason for Cancellation:--None--Financial Issues COVID-19 Cleanliness Lack of Communication Lack of Programming Medical Never Got Started Operating Hours Personal Schedule Change Pool Closure Program Dissatisfaction Relocation Using Another Gym or Home Equipment Cancellation Person to Remove: Cancellation Additional Information: I understand changes to my membership account must be received by the 25th day of the month in order to ensure no charges will take place in the following month. If a membership lapses for more than 30 days, a rejoining fee will apply. Yes, I acknowledge the above hold statement pertaining to my cancellation request. *