Membership Change Form
Please complete the form below to request a change to your current Northfield YMCA membership. These changes can include changing your membership type, adding a new member, or removing a member from your membership. Membership changes will be processed within 3 - 5 business days, and will be backdated to the date this form was submitted.
Sign in to Google to save your progress. Learn more
Email *
Member's Full Name: *
Birthdate: *
MM
/
DD
/
YYYY
Phone number: *
What is your current membership type? *
What type of membership would you like to change to? *
Please list the member/s you would like to remain active on this membership:
List all members you are adding to your membership. You must include: First Name, Last Name, Date of Birth, and Sex.  (Failure to include this information will result in this member not being added to your membership.)
List all members you would like removed from your membership.  You must include: First Name, Last Name, Date of Birth, and Sex. (Failure to include this information will result in this member not being removed from your membership.)
Please note:  If this membership change results in the accrual of additional membership fees for the remainder of the current month, these fees will be added to your membership unit. If you are set up on automatic withdrawal for your membership dues, the additional dues will be processed to your billing method on file. If you are set up on invoice, you will have until the last day of the current month to pay these additional membership fees. By clicking the box below, I understand that all membership changes that have increased my monthly membership dues will continue at the newly requested rate until I complete this form again to notify the Northfield Area Family YMCA of additional change requests. You will receive an email confirmation for the above changes within 3 - 5 business days. Please keep email for your records. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Northfield Area Family YMCA. Report Abuse