Membership Dues Hold Form

Member Name(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
A 30 day advanced notice is required before your next payment. Your membership will automatically reactivate after your scheduled hold expires.
MM slash DD slash YYYY

EFT Draft Membership Agreement Form

  • EFT draft is a continuous membership plan. I understand that this membership will remain in effect if I retain the membership card issued to me and that if I wish to terminate or change my membership in any way, I must give the YMCA a 30-day written notice. I understand that I must turn in all my membership cards for the balance of the time I have paid or will be paying. The YMCA may, at their discretion, adjust the monthly rate applicable to my category of membership. I understand that I will receive at least four weeks notice prior to any such change.
  • I understand that I am still responsible for any payment plus the YMCA will apply a service charge of $20.00 should an EFT draft be declined by my bank or other financial institution. This is in addition to any fee charged by my bank or other financial institution.
  • I hereby authorize YMCA Southcoast to initiate electronic fund entries from my checking account or credit card(s). This authorization remains in effect until the YMCA has received a 30-day written notification from me indicating my desire to discontinue my membership.

Skip to content