Membership Hold Form

1
Hold Effective Date (must read and agree):* This field is required.The YMCA allows hold requests online up to 11:59pm on the last day of the month. Any hold requests submitted on or after 12am on the 1st of the month will not be effective until the following month. By clicking below, you acknowledge that you understand and agree to this policy.
I understand that I must submit my hold request by 11:59pm on the last day of the month or my hold will not be effective until the following month.
2
Hold Guidelines (must read and agree)* This field is required.The YMCA allows members to put their membership on hold one (1) time each calendar year. Members may not utilize the hold benefit more than once per calendar year. At the end of the hold period, the YMCA will begin drafting my billing method on file automatically.
I understand that I may only place my membership on hold one (1) time each calendar year. In addition, I authorize the YMCA to begin drafting my approved billing method once my hold period has concluded.
3
Member Pricing Policy (must read and agree)* This field is required.In order to receive member pricing for YMCA programs, an active YMCA membership is required at time of registration and throughout the duration of the program(s) registered for. Placing a YMCA membership on hold prior to or during a registered YMCA program will result in being charged the difference between the member and non-member price. By clicking below, you acknowledge this policy.
I understand that if I am registered for a YMCA program and place my YMCA membership on hold before or during the program, I am responsible for paying the difference between the member price and the non-member price. I understand that a YMCA staff person will reach out to discuss my options.
4
What is your primary membership branch?* This field is required.Required
Caldwell YMCA
Downtown Boise YMCA
Tomlinson South Meridian YMCA
West Boise YMCA
5
Primary members name:* This field is required.or secondary adult member over the age of 18
First Name
Last Name
6
Email address on file with the YMCA:* This field is required.
example@example.com
7
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
8
Phone number on file with the YMCA:* This field is required.
Area Code
Phone Number
9
I would like to place the following membership type on hold as well as any add-on services currently associated with my membership:* This field is required.
Individual
2-Person Family
Family
Corporate
Insurance Based (Silver Sneakers, Silver & Fit, Renew Active)
10
Please tell us why you are placing your membership on hold:* This field is required.
Medical
Work Related
Financial
Seasonal
Vacation
Spring 2025 50-Meter Pool Closure
Other
11
What month will this hold begin? All holds begin on the first day of the month following the month the hold was requested. For example if you request a hold on May 15th, the hold will begin in June 1st.
12
How long would you like to place your membership on hold for?* This field is required.Hold period begins on the 1st of the month FOLLOWING this request. Membership will reactivate on the 1st of the month 30, 60 or 90 days from hold activation.
One (1) Month
Two (2) Months
Three (3) Months
13
Signature* This field is required.I am requesting to place my YMCA membership on hold for the amount of days specified above. I understand that the hold will be effective on the first day of the month following this request. I understand that during the hold period, I will not have access to any YMCA branch or Nationwide YMCA membership. I understand that on the first of the month, one, two or three months from initial hold date, my payment method on file will be drafted automatically for the same amount as prior to the hold. I understand that any add-on services active on my membership at time of hold will reactivate at the end of the hold as well. I understand that if I do not want my membership to reactivate automatically, I must submit a cancellation request in writing to the YMCA prior to the reactivation date.
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