Complete this form with all information and submit to Member Services.
Credits – Refunds will be reviewed by the Director and submitted to the Associate General Director for approval. Credits will be entered into the system after the approval process is complete.

Refunds take approximately two weeks.

CREDITS – REFUNDS WILL BE GIVEN ONLY FOR THE FOLLOWING REASONS:

• Extended or prolonged illness; a signed Doctor’s excuse must be presented for the credit or refund to be issued. Credit – Refunds will be pro-rated for classes attended.
• Credits – Refunds will be given if the Central Bucks Family YMCA cancels the session due to lack of enrollment. (Director will process this form)
• No Credit – Refund will be given for failure to attend the class during the session.
• Refunds will require a $10.00 processing fee, deducted from the refund along with any attended classes.
• In rare cases of acts of God, ie: lightening or inclement weather conditions, no Credit or Refund will be given.

* Request Type:	Credit     Refund
* Name of Program Participant:
* Parent's Name if Minor:
* Address:
* Email:
* Daytime Phone:
* Total Amount Paid:
* Name of Program or Membership Type:
* Reason for Request:
* Amount of Refund/Credit Requested:
** Submission of this request does not guarantee an agreement for refund or credit. Refunds or credits must be approved by the YMCA. **
	* Required Field