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Membership Change Request

2. First Name*
3. Last Name*
5. Primary Name on the Membership Account, if different
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Primary Phone Number*
16. Secondary Phone Number
18. Email Address*
20. 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
22. 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.

24. Add/Delete from Membership
26. 1.

    1. Add
    2. Delete
27. Name
28. Date of Birth
    Date of Birth
29. Email (if over 18)
31. 2.

    1. Add
    2. Delete
32. Name
33. Date of Birth
    Date of Birth
34. Email (if over 18)
36. 3.

    1. Add
    2. Delete
37. Name
38. Date of Birth
    Date of Birth
39. Email (if over 18)
41. 4.

    1. Add
    2. Delete
42. Name
43. Date of Birth
    Date of Birth
44. Email (if over 18)
46. When will this change 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.
48. Do you have any comments or questions?
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field