Membership Update Form

Membership Information

* What would you like to do?

* Member Name

Your Membership Number is located on your membership card

Membership Number ?

* Address

* City

* State

* Zip Code

* Email

* Phone

*New Address?

Please Note: If you are updating your billing information, please contact the JCCSF or log into your JCCSF account.

Membership Hold Status

* Hold Status

You may request hold status for a minimum of one (1) month and a maximum of six (6) months per twelve (12) month period and all dues and outstanding charges must be paid in full. Approved requests for hold status received on or before the first calendar day of the month will become effective on the last day of that month. Approved requests received on the second calendar day of the month will become effective on the last calendar day of the following month.

Choose Starting and Ending dates for hold status:

* Starts on the 1st of:

* Resumes on the 1st of:

* Reason for hold

* I understand written notice from my doctor is required to place my account on medical hold and waive the monthly fee. Doctor notice can be faxed to 415.276.1555, email to accountservices@jccsf.org, or given to the Front Desk. Medical holds are not effective until written doctor's notice has been received.

Initial:

* I understand there is a monthly hold fee billed automatically to my account. The monthly hold fee is $25 per Adult, $50 per Family, or $15 per Limited or Teen memberships.

Initial:

* I understand my regular monthly dues will resume without further notice at the end of the hold period indicated unless I provide additional written notification to the JCCSF.

Initial:

Please Note:

  • You may use the fitness facilities during your hold status by paying a day-use guest fee. Not valid for medical holds.
  • If you are cancelling your JCCSF Swim School swimming lessons enrollment please email: swimlessons@jccsf.org. Class withdrawals must be provided in writing and received by the JCCSF Aquatics Office by the 18th of the month to withdrawal from the subsequent month of lessons.

To restart your membership, please request reactivation at the front desk on your way in to work out. A prorated portion of your regular membership dues, less any hold fees paid for the month, will be charged when reactivating early.

Membership Resignation

* Reason for resignation

*New Address?

*Would you like to apply for financial assistance?

Please keep in mind that you may temporarily suspend your membership for up to six months in a twelve month period. For this option, please change your request to "Membership Hold Status."

If you are resigning your membership due to a medical condition, please keep in mind you can temporarily suspend your membership for up to six months within a twelve month period with no additional fee. For this option, please change your request to "Membership Hold Status".

Doctor notice required to waive 30 day cancel policy.

*Please choose:

*Please Explain:

*Please Explain:

*Please Explain:

* Are you cancelling your membership or your family membership?

* Are any members on the account continuing their membership?

Please list the members:

* Do you have locker/laundry service?

(If yes, your service will be cancelled)

* All resignation requests received by JCCSF between the first calendar day of the month and the 25th calendar day of the month will become effective 30 days after the date of receipt. The billing for the final calendar month will be prorated to exclude any days falling outside of the 30 day period. Resignation notices received by JCCSF on or after the 26th of the month will become effective on the last day of the following month and will not be prorated.

 

Resignation Effective: June 25, 2015

 

Initial:

* I agree that by submitting this form I have read and agree to the resignation terms. Dues will continue to accrue until the resignation effective date and balances not paid in full will be subject to further collection efforts.

Initial:

Please Note: If you are cancelling your JCCSF Swim School swimming lessons enrollment please email: swimlessons@jccsf.org. Class withdrawals must be provided in writing and received by the JCCSF Aquatics Office by the 18th of the month to withdrawal from the subsequent month of lessons.