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2. First Name*
3. Last Name*
5. Primary Name (First and Last) on the Membership Account, if different
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Primary Phone Number*
17. Email Address*
19. What change are you requesting? (Please select all that apply)*

    1. Add someone to my membership
    2. Remove someone from my membership
    3. Change my membership type
    4. Extend Summer Pass to ongoing membership
21. If you selected I wish to change my membership type, please include details here.

    There is a $25 fee for upgrades to Family or Couples Special Hours memberships.

23. Add/Delete from Membership
25. 1.

    1. Add
    2. Delete
26. First Name
27. Last Name
28. Date of Birth
    Date of Birth
30. Email (if over 18)
32. 2.

    1. Add
    2. Delete
33. First Name
34. Last Name
35. Date of Birth
    Date of Birth
37. Email (if over 18)
39. 3.

    1. Add
    2. Delete
40. First Name
41. Last Name
42. Date of Birth
    Date of Birth
44. Email (if over 18)
46. 4.

    1. Add
    2. Delete
47. First Name
48. Last Name
49. Date of Birth
    Date of Birth
51. Email (if over 18)
53. When would you like this change to be effective? *
    • Please provide month and year (MM/YY).
    • For bank draft changes and downgrades, 15 days' notice is required. 
    • Prorated membership fees may apply for upgrades based on effective and draft dates.
55. Do you have any comments or questions?
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field