Membership Change Forms - JCCNS, Jewish Community Center of the North Shore

Please select a form below for any Membership changes. Please note that all membership change requests must be put in writing by the 15th of the previous month. For questions, contact Membership Director Andrew Dalton at adalton@jccns.com.

Membership Change Form

Membership Change Request

Fields marked with an * are required

Main Member First Name *

Member Last Name *

Member Email *

Confirm Email *

Current Membership type *

* Please note: Children on Family Memberships must be under 23 years of age.

Health Centers

Men’s Health Center - $47
Women’s Health Center - $46
Couple Health Center - $83

Please select below if you are a Current Member of a Health Center

What would you like to change? *

Membership Type
Health Center (add/drop)
Add/Drop Members

Divider

STATUS CHANGE

NEW Membership type

Please select your NEW Membership Type (or select Stay the Same if adding Health Centers or adding/dropping members)

* Please note: Children on Family Memberships must be under 23 years of age.

Divider

ADD/DROP HEALTH CENTERS

ADD Health Centers

Men’s Health Center - $47
Women’s Health Center - $46
Couple Health Center - $83

DROP Health Centers

Men’s Health Center - $47
Women’s Health Center - $46
Couple Health Center - $83

Divider

ADD/DROP MEMBERS

ADD/DROP 1

Add
Drop

First Name 1

Last Name 1

DOB 1

Relationship 1

HTML

ADD/DROP 2

Add
Drop

First Name 2

Last Name 2

DOB 2

Relationship 2

ADD/DROP 3

Add
Drop

First Name 3

Last Name 3

DOB 3

Relationship 3

Divider

TERMS OF ACCEPTANCE and SIGNATURE Electronic Signature *

All membership change requests must be put in writing by the 15th of the previous month.

Please type your FULL First and Last Name below:

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *

If you are a human seeing this field, please leave it empty.

Membership Freeze Form

Membership Freeze Request

Fields marked with an * are required

Membership can be placed on hold ...

Membership can be placed on hold for a minimum of 1 month and a maximum of 6 months in a calendar year. If your request is due to a medical reason, please provide us with documentation from your doctor.

Member First Name *

Member Last Name *

Member Email *

Confirm Email *

Please Select Months to be Frozen *

January
February
March
April
May
June
July
August
September
October
November
December

All freezes start on the first of the month and end on the last day of the month.

TERMS OF ACCEPTANCE and SIGNATURE Electronic Signature *

All membership change requests must be put in writing by the 15th of the previous month.

Please type your FULL First and Last Name below:

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *

If you are a human seeing this field, please leave it empty.

Membership Cancellation Form

Membership Cancellation Request

Fields marked with an * are required

Member First Name *

Member Last Name *

Member Email *

Confirm Email *

Requested Cancellation Date: *

Must be by the 15th of the month.

Reason for cancelling membership (please select all that apply) *

Not enough value for cost of membership
Not enough time in my day / Lost motivation
Moved/changed jobs and the JCCNS is no longer close by
Not affordable
Dissatisfied with staff responsiveness
Facility is not clean/well-maintained
Not the desired equipment
Program Ended
Inconvenient JCCNS schedule
Child aged out of child care
Parking issues
Health/medical reasons
Other

Please provide more information:

Are you planning on joining another health/fitness provider? *

What would it take to get you back as a member of the JCCNS? *

TERMS OF ACCEPTANCE and SIGNATURE Electronic Signature *

All membership change requests must be put in writing by the 15th of the previous month.

Please type your FULL First and Last Name below:

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *

If you are a human seeing this field, please leave it empty.

Membership Change Request

Fields marked with an * are required

Main Member First Name *

Member Last Name *

Member Email *

Confirm Email *

Current Membership type *

* Please note: Children on Family Memberships must be under 23 years of age.

Health Centers

Men’s Health Center - $47
Women’s Health Center - $46
Couple Health Center - $83

Please select below if you are a Current Member of a Health Center

What would you like to change? *

Membership Type
Health Center (add/drop)
Add/Drop Members

Divider

STATUS CHANGE

NEW Membership type

Please select your NEW Membership Type (or select Stay the Same if adding Health Centers or adding/dropping members)

* Please note: Children on Family Memberships must be under 23 years of age.

Divider

ADD/DROP HEALTH CENTERS

ADD Health Centers

Men’s Health Center - $47
Women’s Health Center - $46
Couple Health Center - $83

DROP Health Centers

Men’s Health Center - $47
Women’s Health Center - $46
Couple Health Center - $83

Divider

ADD/DROP MEMBERS

ADD/DROP 1

Add
Drop

First Name 1

Last Name 1

DOB 1

Relationship 1

HTML

ADD/DROP 2

Add
Drop

First Name 2

Last Name 2

DOB 2

Relationship 2

ADD/DROP 3

Add
Drop

First Name 3

Last Name 3

DOB 3

Relationship 3

Divider

TERMS OF ACCEPTANCE and SIGNATURE Electronic Signature *

All membership change requests must be put in writing by the 15th of the previous month.

Please type your FULL First and Last Name below:

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *

If you are a human seeing this field, please leave it empty.

BUILDING HOURS:

Monday: 6am – 8pm
Tuesday: 6am – 8pm
Wednesday: 6am – 8pm
Thursday: 6am – 8pm
Friday: 6am – 6pm
Saturday: 7am – 5pm
Sunday: 7am – 5pm

CONTACT:
(857) 285-7900

DIRECTIONS:
4 Community Road
Marblehead, MA 01945

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Our Mission
Early Childhood Program
J Adventure After-school
Summer at the J Camps
Adult Programs
Fitness Offerings
Personal Training
Handyman at the J

Our Mission

Early Childhood Program

J Adventure After-school

Summer at the J Camps

Adult Programs

Fitness Offerings

Personal Training

Handyman at the J

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