Membership Cancellation Form

Policy:

If you wish to cancel your membership with us, we ask that you please fill out and submit our form below.

Please Note:

• Cancellation requests must be made at least fifteen (15) days prior to the month in which it will take effect. For example: for a cancellation to take effect November 15^th, the request must be submitted by November 1st.

• If you miss the fifteen (15) day notice deadline, you will be responsible for the following month’s membership dues.

Please fill out and submit the form below to request your membership cancellation.  You will receive a confirmation within forty-eight (48) hours.

IMPORTANT:  If you do not receive a confirmation email within forty-eight (48) hours, please call our Front Desk at 617-625-5050 or email [email protected].

Thank you!

Full Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

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Zip Code

Membership Type *

• General Membership
• Women's Health Center
• Men's Health Center
• Family

Length of Membership *

• Less than 6 Months
• Over 6 Months
• Over 1 Year
• Over 5 Years

Reason for Cancellation *

• Relocation
• Financial Reasons
• Medical Reasons
• No Longer Using Facilities
• Switching to Another Facility
• Dropping for Summer/Winter
• Dissatisfied with Facilities
• Other

What rating would you give the Somerville YMCA Facilities *

• Excellent
• Good
• Average
• Poor

What was the primary reason you joined the YMCA *

• Location
• Facilities
• Cost
• YMCA Mission
• Other

Which Features did you use the most? *

• Pool/Aquatics
• Cardio Equipment
• Indoor Track
• Olympic Lifting Room
• Basketball Court
• Nautilus Room (Cardio)
• Yoga
• Bootcamp
• Pickleball

Date you would like to cancel *

15 day notice from payment date is required, if it is after the 15 days you will be responsible for the next months payment.

Submit