Membership Hold Request

IMPORTANT: Any requests for membership holds must be submitted 5 days prior to your draft date.

First

Last

Phone Number

Please select your home branch:

Reason for hold

Comments/Questions

Program Registrations

I understand that if I put my membership on hold, I may be charged non-member rates for programs my unit is enrolled in, if applicable.

I agree

Draft Date Agreement

If I am paying monthly, I understand that this notice must be received (5) five days in advance of my draft. I will be responsible for payment of drafts if (5) five days advance notice is not received and will not qualify for a refund.

I agree

Verification

It is my responsibility to verify that the hold was successful and the Y is no longer taking membership fees out of my account. I understand that the Y is not responsible for reimbursing membership fees for more than (1) one month after my date of hold request.

I agree

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