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Litehouse YMCA Membership Change Form

LITEHOUSE YMCA Membership Change Form

Home Branch

Please complete this form if you wish to Activate or Deactivate your LITEHOUSE Y Membership. Do not use this form if you are a SWAC Legacy or Payroll Deduct Member, you will need to call us at 208 263 663

Primary Member's Date of Birth *

Primary Member First Name *

Primary Member Last Name *

Email *

Phone *

Address/City/State/Zip *

Membership Change Options: * Membership Change Options:

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