Membership Change Form

1
What is your primary membership branch?* This field is required.
Caldwell YMCA
Downtown Boise YMCA
Tomlinson South Meridian YMCA
West Boise YMCA
2
Primary members name:* This field is required.or secondary member over the age of 18
First Name
Last Name
3
Email address on file with the YMCA:* This field is required.
example@example.com
4
Street Address:* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Phone number on file with the YMCA:* This field is required.
Area Code
Phone Number
6
What type of change would you like to make to your membership?* This field is required.
Reinstate a pre-existing membership
Add or remove individuals to/from my membership
Add or remove services to/from my membership
Change my emergency contact
Update my billing method
Other (please specify and a membership specialist will contact you shortly)
7
What type of membership did you have prior to termination?* This field is required.* Short term & corporate memberships require in-person reactivation
Adult Individual 30-64
Young Adult Individual 19-29
Senior Individual 65+
Youth Individual 10-18
2-Person Family
Family
Virtual Only
Renew Active
Silver & Fit
Silver Sneakers
Other/ Not Sure
8
What type of membership would you like to activate at this time?* This field is required.* Short term & corporate memberships require in-person reactivation
Adult Individual 30-64
Young Adult Individual 19-29
Senior Individual 65+
Youth Individual 10-18
2-Person Family
Family
Virtual Only
Renew Active
Silver & Fit
Silver Sneakers
9
Do you need to add or remove individuals from your newly reinstated membership?* This field is required.
YESNO
10
Are you adding or removing individuals from your membership? * This field is required.All individual memberships are allowed only one (1) active member. 2-Person Family is defined as 2 adults in a domestic partnership OR 1 adult and 1 dependent child, age 23 or younger. Family membership is defined as 2 adults in a domestic partnership and their dependent children, age 23 or younger OR 1 adult and 2 or more dependent children, age 23 or younger.
AddingRemoving
11
Please ADD the following individual to my account:* This field is required.* All adults age 18+ must present with valid, government issues photo ID upon first visit to the YMCA. For more information on acceptable documents, click here.
First Name
Last Name
12
Age:* This field is required.
13
Gender:* This field is required.
Male
Female
Prefer not to say
14
Relationship to primary member:* This field is required.
15
Do you need to ADD another member?
YESNO
16
Please ADD the following individual to my account:* All adults age 18+ must present with valid, government issues photo ID upon first visit to the YMCA. For more information on acceptable documents, click here.
First Name
Last Name
17
Age:
18
Gender:
Male
Female
Prefer not to say
19
Relationship to primary member:
20
Do you need to ADD another member?
YESNO
21
Please ADD the following individual to my account:* All adults age 18+ must present with valid, government issues photo ID upon first visit to the YMCA. For more information on acceptable documents, click here.
First Name
Last Name
22
Age:
23
Gender:
Male
Female
Prefer not to say
24
Relationship to primary member:
25
Do you need to ADD another member?
YESNO
26
Please ADD the following individual to my account:* All adults age 18+ must present with valid, government issues photo ID upon first visit to the YMCA. For more information on acceptable documents, click here.
First Name
Last Name
27
Age:
28
Gender:
Male
Female
Prefer not to say
29
Relationship to primary member:
30
Please REMOVE the following individual from my account:* This field is required.
First Name
Last Name
31
Age:* This field is required.
32
Gender:* This field is required.
Male
Female
Prefer not to say
33
Relationship to primary member:* This field is required.
34
Do you need to REMOVE another member?
YESNO
35
Please REMOVE the following individual from my account:
First Name
Last Name
36
Age:
37
Gender:
Male
Female
Prefer not to say
38
Relationship to primary member:
39
Do you need to REMOVE another member?
YESNO
40
Please REMOVE the following individual from my account:
First Name
Last Name
41
Age:
42
Gender:
Male
Female
Prefer not to say
43
Relationship to primary member:
44
Do you need to REMOVE another member?
YESNO
45
Please REMOVE the following individual from my account:
First Name
Last Name
46
Age:
47
Gender:
Male
Female
Prefer not to say
48
Relationship to primary member:
49
Would you like to add/remove any services to your membership?* This field is required.* Services include towels, lockers, Kid Zone & personal training
YESNO
50
Would you like to ADD or REMOVE services from your membership?* This field is required.
AddRemove
51
What services would you like to add to your membership?* This field is required.
Individual Towels @ $6/month
Family Towels @ $12/month
Locker Rental @ $15/month
Kid Zone for 1 Child @ $27/month
Kid Zone for 2+ Children @ $39/month
Kid Zone for 1 Child (Individual adult in which child is not an active member) @ $33/month
Monthly Personal Training (must be approved by a Health & Well-Being staff member)
52
If adding Kid Zone, please specify the name, age & gender of each child you wish to add (skip if not applicable):* Kid Zone is for youth ages 6 weeks through 6 years of age. For more information click here
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53
What services would you like to REMOVE from your membership?* This field is required.
Individual Towels @ $6/month
Family Towels @ $12/month
Locker Rental @ $15/month
Kid Zone for 1 Child @ $27/month
Kid Zone for 2+ Children @ $39/month
Monthly Personal Training (Must be approved by a Health & Well-Being staff member)
54
If removing Kid Zone, please specify the name, age & gender of each child you wish to remove (skip if not applicable):* Kid Zone is for youth ages 6 weeks through 6 years of age. For more information click here
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Ok
55
Do you need to update your emergency contact on file with the YMCA?* This field is required.
YESNO
56
Emergency contact name: * This field is required.
First Name
Last Name
57
Emergency contact phone number:* This field is required.
Area Code
Phone Number
58
Your relationship to emergency contact: * This field is required.
59
Do you need to update your billing method on file with the YMCA?* This field is required.
YESNO
60
Updating Billing Method* This field is required.In order to ensure the safety of our members sensitive information, the YMCA does not update billing methods through this portal. If you would like to update your payment method please contact your local Branch. Contact information can be found here.
I understand that I cannot update my billing method through this portal and will update it by contacting my local branch.
61
Other Changes: If you would like to request a change that was not included in this form, please specify below and a YMCA staff member will contact you shortly. If no further changes are requested, please click submit below.
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Ok
62
All membership downgrades and removal of services will be effective on the first day of the month following receipt of this request. Reactivations, upgrades and add-ons can be effective upon receipt of this request form (at a prorated fee) OR at the beginning of next month. If you are reactivating, upgrading or adding a new service, please specify when you would like the changes to go into effect:If not applicable, please skip this question
Please make changes effective nowPlease make change effective on the 1st day of next month
63
Please note; no change is finalized until you connect with a YMCA membership specialist. A specialist will reach out within 2 business days of receipt of this form* This field is required.
I understand that a YMCA staff member will reach out in order to finalize this change request.
64
Signature* This field is required.By signing below, I am authorizing the Treasure Valley Family YMCA to make all changes to my membership as outlined in this request form. I understand that all requested changes will be effective on the 1st day of the month following this request and I understand that they may change my monthly fee.
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