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Ches Penney YMCA Membership Cancellation Form
YMCA
2022-02-16T12:42:50-03:30
Home
Ches Penney YMCA Membership Cancellation Form
Ches Penney YMCA Membership Cancellation Form
Your Name
(Required)
First
Last
Your Birthday
(Required)
Day
Month
Year
Your Phone Number
Your Email Address
List the name of the member(s) on the account whose membership is to be cancelled:
Person 1
(Required)
Person 2
Person 3
Person 4
Person 5
Person 6
Person 7
Please tell us why each membership is cancelling at this time:
(Required)
Are any members that are being cancelled today enrolled in programs such as group swim lessons, Karate or After Day Play?
(Required)
Yes
No
Confirm Cancellation
(Required)
By clicking the "I Agree" box below, I confirm that I wish to cancel the above noted memberships, and that I have read, understand, and agree to the cancellation process and specifically the terms below.
I am the payer on the accounts I have indicated for cancellation above, and understand if I am not, the membership(s) will not be cancelled, and the payer will need to submit this form.
I understand that the payer must provide a written/email request a minimum of 15 days before the scheduled payment date to cancel. If not within this minimum notice period, the normal scheduled payment will occur, and the membership will remain active for that paid period. Verbal requests to cancel are not accepted. When processed, the payer will receive a cancellation confirmation via the email address listed on file. Facility access remains active until the last day of your payment period. Cancellation fees are included in your Joiner Fee. If there is a balance owing on your account, this must be paid before you can cancel.
I Agree
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