Program Changes

Program Changes and Cancellation Request Form

Free Text

Please allow up to 2 business days to receive a response. If you do not receive a response after 2 business days, please contact Customer Service at 225-767-9622.

Full name of participant

DOB:

Member phone number:

Address:

Name of Parent or Guardian (if participant is under 18)

Please select the location of your program registration

What do you need to change about your program order?

Program Type

Please provide the date(s) of the program you wish to change/cancel:

For transfers only: New Program Type

For transfers only: New Program Location

For Transfers Only: New Program Dates

Any additional information:

Reason for change:

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By submitting this form, you agree to the terms and conditions of the YMCA of the Capital Area and its cancellation and refund policies.

**Please note, this form serves as a request for a program change and/or cancellation. The change or cancellation will not take effect immediately. Please wait for an email from a program staff member that will serve as confirmation for completion of the request.**

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MISSION

To put Christian principles into practice through programs that build healthy spirit, mind and body for all.

Program Changes and Cancellation Request Form

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