Online Membership Hold Request Request to Hold Membership (automatically continue monthly payments at end of hold). Member Name*Must be name of person holding this membership (primary member). First Last Barcode Number5 digit number used to check-in.Member Email Address*Email required to send confirmation. Enter Email Confirm Email Member Birth Date* MM DD YYYY Member Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Member Home Phone*Member Cell Phone*Select up to two membership hold months below (must be consecutive). May only make one membership hold request per month; membership must reactivate prior to next membership hold request.*If more than two months or two non-consecutive months are selected, your request will be denied and will need to be resubmitted. January February March April May June July August September October November December Reason for hold*SeasonalScheduleVacationTravelAdditional information to take into consideration regarding your membership hold request?(Optional)Please read each statement below, then select each checkbox as receipt of acknowledgement.*All statements must be accepted in order to process the hold request. I understand that the billing on this account will be charged one more month, prior to the hold, if a seven-day notice prior to the billing date is not provided. I understand that the billing on this account must be up to date prior to the end of this hold to avoid declined payment fees. I understand that billing cannot be due to expire over the course of this hold or the membership will terminate rather than hold. Memberships terminated longer than two months will be reassessed the development fee (fee does not apply to youth memberships). Billing may be updated by calling the Membership Service Desk at 724-452-9122. I understand family members cannot be registered in any program that runs during membership hold. Account will be charged non-member price difference for program if membership hold is submitted. Authorized Signature*I, the requesting party, understand there is a required seven-day notice prior to my billing date before this membership hold will commence. (Billing date of 1st of month or 15th of month is given based on your chosen preference when you joined.) Typing your name below will act as your authorized signature, by which you agree to the terms listed throughout. First Last Membership Hold is NOT COMPLETE until member receives emailed confirmation of this request. An email confirmation will be sent once your request is processed, detailing your last payment date.