Membership Cancellation Request Form

South Shore YMCA Membership Cancellation Request

Submit this form if you wish to cancel your South Shore YMCA membership.

  • MM slash DD slash YYYY
  • The day of the month that your membership dues are drafted from your bank or credit card account. Often the 1st or 15th of the month.
  • Choose one
  • Choose any additional reasons that apply
  • You may opt to remain a "Meaningful Member" and convert your monthly membership dues to a tax-deductible donation. Our team can provide details.