30 Day Cancelation Notice

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We are sorry to see you go but we understand all good things must come to an end. Please complete this form in its entirety including the acknowledgements at the end. Please ensure your Y account has up to date contact information (permanent mailing address, phone & email). The information gathered on this form will help us improve our

We look forward to welcoming you back to our Y in the future. If you are moving, we hope you will support the YMCA in your new community.

Please note that by completing this form, your are indicating that you understand you are responsible for any final payments that fall within 30days of the completion of this 30 Day Cancelation Notice

Email *

Member ID Number (Ask a Y Staff For This If You Don't Know) *

Member First Name *

Member Last Name *

Member Phone Number *

Member Email *

Would you be interested in joining the YMCA of Sandusky County in the future? *

Yes

Maybe

What was your primary reason for joining *

General Fitness (stay in shape, get fit, get healthy, etc.))

Youth Programing

Group Fitness Classes

Use of The Pool

To Get Discounts On Child Care

Specific Health Related Issue (diabetes, high blood pressure, obesity, heat disease, etc.)

What is your reason for canceling your membership *

Facility/Program Issues

Health Issues

Lack Of Use

Moved Away

Financial Reasons

Joining Another Facility

Military Deployment

Primary Reason (Select One)

Secondary Reasons (Select All That Apply)

If joining another facility what amenities do they have that the Y does not? If not joining another facility write NA. *

If moving please list what city you are moving to. If not moving please write NA. *

Please rate the Y *

Excellent

Good

Fair

Poor

NA/Didn't Use

Facility

Staff Knowledge

Staff Friendliness

Youth Programs

Adult Programs

Fitness Classes

ChildCare

ChildWatch

What would you like us to know about your experience? Type NA if you would like to leave this section blank *

By typing my name below I am verifying that I understand that this is a 30 day cancelation notice.
*

By typing my name below I am verifying that I understand that I am responsible for a final payment that will be collected on the 5th of the month falling within 30 days from the completion of the form.
*

A copy of your responses will be emailed to the address you provided.

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