Membership or Program Refund/Credit Request Form

Request a Refund or Credit

"*" indicates required fields

Participant/Member Name*

First Last

Payer Name*

First Last

Payer Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Refund/Credit Request*

Please select a refund/credit option.

Program Session*

Please select which session you are requesting a refund or credit.

Camp Session*

Please select which session you are requesting a refund or credit.

Reason for Membership Credit/Refund Request*

Membership refunds are only eligible for members who cancel within their first 30 days of joining.

Program Name*

Program Day/Time*

Reason for Program Refund/Credit Request*

Our mission is to enrich all people in spirit, mind, and body. In order to provide quality programs in a safe environment with proper instructor/participant ratios, we must limit the circumstances and time frame in which we can provide refunds. All outstanding fees and charges will be settled prior to the issuance of refunds or credits.

Camp Name*

Camp Day/Time*

Reason for Camp Refund/Credit Request*

All outstanding fees and charges will be settled prior to the issuance of refunds or credits.

I acknowledge that I have read and understand the refund/credit policies of the New Canaan YMCA (see policies below)*

Payer Signature

Date*

OUR 30-DAY MEMBERSHIP GUARANTEE:

We welcome new members and hope they are satisfied with every aspect of their YMCA experience. New members who are not pleased with membership may submit a refund request to the Member Services Desk, within the first 30 days of joining for a full refund of membership and joiner fees.

PROGRAM REFUND/CREDIT POLICY:

Program Cancellations by the Y:

• If the Y cancels a program prior to the commencement date, a full refund will be issued. The YMCA reserves the right to cancel any program that fails to meet enrollment requirements.

• If the Y cancels a program meeting date or dates, every effort will be made to schedule a make-up date. If a make-up date is offered, no credits or refunds will be issued, regardless of whether participants are able to attend the make-up date. If the Y cannot schedule a make-up date, a credit will be issued for the cancelled date(s).

• Refund requests after participant withdrawal from a program must be made to at least five business days prior to the program commencement date, and are subject to a $15 processing fee.

• After a program commences, pro-rated refunds will be issued only for withdrawal due to medical reasons, verified in writing by a physician. Refund requests must be submitted no later than the last day of the session.

CAMP REFUND POLICY:

Camp Cancellations by the Y:

• If the Y cancels a session of camp prior to the commencement date, a full refund will be issued. The YMCA reserves the right to cancel any camp program/session that fails to meet enrollment requirements.

• Full refunds will be issued for camper withdrawal due to a medical reason, verified in writing by a physician, provided the request is made before the first day of the camper’s session. Thereafter, refunds for medical reasons will be pro-rated.

Camper Withdrawal:

• Refunds due to camper withdrawal will be issued as follows: Requests made during the month of January (full refund). Requests made during the month of February (80% refund). Requests made during the month of March (40% refund). Requests made during the month of April (20% refund). No refunds will be issued after May 1.

• Pro-rated refunds will be provided for camper withdrawals due to a medical reason, with written verification from a physician.

*All refunds resulting from withdrawal are subject to a $15 processing fee per participant/session. Refund/Credit Request form must be submitted prior to the last day of the session.

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