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    Credit/Refund Form

    Complete this form with all information and return to Member Services. Credits/Refunds will be reviewed 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/Refund 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. In rare cases of acts of God, ie: lightening or inclement weather conditions, no Credit or Refund will be given. Refunds will require a $10.00 processing fee, deducted from the refund along with any attended classes.
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    *Today's Date:
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    *Name of Program Participant:
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    Parent's Name if Minor:
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    *Address:
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    *City, State, Zip:
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    *Daytime Phone:
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    *Email Address:
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    *Name of Program or Membership Type:
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    *Total Amount Paid:
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    *Reason for Request:
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    *Amount of Refund/Credit Requested:
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    Submission of this request does not guarantee an agreement for refund or credit. Refunds or credits must be approved by the Y.
CENTRAL BUCKS FAMILY YMCA | 2500 Lower State Road | Doylestown, PA | 215.348.8131

MISSION: Central Bucks Family YMCA is a charitable non-profit organization whose purpose is to improve the quality of community life. The Y strengthens the spirit, mind and body of its members. We build character by promoting the values of caring, respect, honesty and responsibility.

The Y is committed to providing programs that build a healthy spirit, mind and body for all. We make every effort to ensure that no one is turned away due to inability to pay. Click to read more about our financial assistance.

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