YMCA of Metropolitan Washington Membership Cancellation Form

We are sorry to learn that you wish to discontinue your YMCA membership at this time. Please complete this form and answer all questions asked so that the YMCA can best support you. After you have successfully completed this form, unless you have indicated that you'd like to speak with a Y team member about the possibility of continuing your YMCA membership, your Y membership will be cancelled in accordance with the policies outlined in the membership handbook (https://www.ymcadc.org/membership-handbook/). If you have any questions, please email member.service@ymcadc.org.

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* 1. Please provide your name and contact information. Your YMCA member identification number can be found on the back of your membership identification card.

Name *

YMCA Member ID #

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. Please select your home branch location.

YMCA Alexandria

YMCA Anthony Bowen

YMCA Arlington

YMCA Bethesda Chevy-Chase

YMCA Fairfax County Reston

YMCA SIlver Spring

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* 3. When did you join the YMCA?

10 or more years ago

5 - 9 years ago

3 - 4 years ago

1 - 2 years ago

About 7 - 12 months ago

About 3 - 6 months ago

Within the past two months

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* 4. What was the primary reason you joined the YMCA?

I joined to achieve a specific healthy living goal (i.e. lose weight)

I joined to simply start or maintain a healthy, active lifestyle

I joined to spend more time with family/friends

I joined to support my/my family's participation in YMCA programs (i.e. camp)

I joined to meet new people and to be social

I joined to support my community

I joined for another reason (please specify)

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* 5. Was the reason that you joined the YMCA satisfied/achieved?

Yes

Unsure

Please share any details you'd like the YMCA to know

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* 6. What did you enjoy most about your experience with the Y?

The YMCA staff

The YMCA members

The YMCA programs / services

The amenities of the YMCA facility that I utilized

The YMCA facility location

The overall YMCA membership value

Other (please specify)

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* 7. How many days per week did you normally go to the Y?

Once per week

Twice per week

Three times per week

Four or more times per week

I am unsure

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* 8. When you visited the Y, did you normally go...

by yourself

with 1 friend or family member

with 2 or more friends or family members

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* 9. At the Y, did you normally... (please select all that apply)

Participate in an instructor-led large group activity (i.e. group exercise class)

Meet up with friends or participate in a small group activity

Workout with YMCA staff (i.e. personal training, swim instruction, etc.)

Workout by yourself

Use the wellness center (i.e. free weights, cardio equipment)

Swim in the pool

Play tennis

Play pickleball

Play basketball

Participate in a YMCA program

My child participated in a YMCA program

Other (please specify)

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* 10. What is the main reason you want to discontinue your membership at this time (please select one)?

I am moving out of the area

I have changed jobs / no longer convenient

The program I participated in has ended

I joined the Y to utilize a service for a particular season that has ended

My family / friends are no longer visiting the Y

My family's child care program / camp has ended

My family is growing (adoption or new baby)

I have lost motivation

I have joined another facility (i.e. gym, pool)

There is a workout facility at work/in my home/ at my apartment

Health reasons

Financial: currently seeking employment / in-between jobs

Financial: personal income or expenses have changed. Can no longer afford

I am dissatisfied with the equipment

I am dissatisfied with the facility

I am dissatisfied with the operating hours

I am dissatisfied with a change in YMCA services

I am dissatisfied with the facility cleanliness

I am dissatisfied with YMCA service quality

Other (please specify)