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Membership Hold Request

2. Primary Member Information

4. Last Name*

5. First Name*

7. Primary Phone Number*

8. Secondary Phone Number

10. Email Address*

12. Address *

14. City*

15. State*

16. Zip*

18. Hold Request & Policy

20. Holds are free of charge through 6/30/21. There is a $15 charge per month for holds past 7/1/21. Hold start date must be 15 or more days from today’s date. Holds requested with less than a 15-day notice will not be processed.

22. Hold to be effective for (please check one):*

    1. 1 month
    2. 2 months
    3. 3 months

24. Hold Policy: The CRC requires a minimum 15-day notice to place a membership on hold. The Membership Hold fee is $15 per month (fee waived for memberships on hold until 6/30/21). A membership may be placed on hold for a maximum of three months each year. DRAFTED MONTHLY: Hold begins and ends on the current draft date (1st or 15th of month). ANNUAL MEMBERSHIP: Hold begins and ends on the 1st of the month.

    Hold Policy: The CRC requires a minimum 15-day notice to place a membership on hold. The Membership Hold fee is $15 per month (fee waived for memberships on hold until 6/30/21). A membership may be placed on hold for a maximum of three months each year. DRAFTED MONTHLY: Hold begins and ends on the current draft date (1st or 15th of month). ANNUAL MEMBERSHIP: Hold begins and ends on the 1st of the month.

26. Start Month*
    -- Select One --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

27. Start Date*
    -- Select One --1st15th

29. Membership Type (Check all that apply)*

    1. Adult
    2. Family
    3. Youth/Teen
    4. Special Hours

    1. Special Hours Couple
    2. Adult Plus*
    3. Splash Aquatics*

31. *List each Adult Plus or Splash Aquatics member under your account.

33. Reason for Hold*
    -- Select One --COVID-19Temporary RelocationFinancialTravel/VacationSchedule ChangesSenior Programs UnavailableSplash Season PauseKids Club ClosureOther (please describe below)

35. Other Reason for Hold

37. Confirmation

39. Comments

41. Acknowledgement Required: *

    1. I understand the CRC is placing my membership on hold for the time period requested above. This action will pause my bank draft through June 2021.
    2. I acknowledge that my checking account will be drafted $15 per month if I request a membership hold past 7/1/21.

43. Member Signature*

    Please type name to sign.

45. Please include date and time
    Please include date and time

    Please include date and time

Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field