Membership Hold Request Form
You may hold your monthly membership draft up to 3 months per year. Please complete the form below to submit your request.  By completing this form you authorize the Regional YMCA to skip a monthly draft. I understand that my draft will automatically restart on the following month.
  • All membership hold requests must be submitted by the 25th of the month to be effective starting the next month. 
  • Members may not use the facilities while their membership is on hold.  Access will resume automatically when the draft restarts.  
  • To reactivate your membership before the scheduled restart date, please contact the Membership Service Desk at 203 775 4444.  
For any questions contact Janice Waterbury at jwaterbury@regionalymca.org or Megan Hebert at mhebert@regionalymca.org
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Email *
Members First and Last Name *
Members Address *
Members Phone Number *
I would like to hold my membership for: *
Required
Reason for membership hold *
A copy of your responses will be emailed to the address you provided.
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