YMCA of the
Inland Northwest
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Litehouse YMCA Membership Change Form
LITEHOUSE YMCA Membership Change Form
Home Branch
Litehouse YMCA
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:
*
Choose an option:
I am ready to come back to the Y! Please ACTIVATE my membership. I understand that I will be charged for prorated membership dues for the existing month. (Allow 2 business days for processing)
I would like to speak with a Membership Director about a reduced rate due to financial hardship
This is my written request to cancel my YMCA membership. I understand that the Membership Director will contact me within 72 hours by phone or email to complete this request.
Membership Change Options:
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