Change OhioHealth Membership

OhioHealth/YCO Corporate Membership Program

Change Your Membership
Your Name*

First NameLast Name
OhioHealth Clock Number*
Any OhioHealth associate is eligible for the preferred YMCA adult or household rate via payroll deduction.

However only associates on the OhioHealth medical plan or Opt-in to Wellness are eligible for the OhioHealth/YCO Corporate Membership Program quarterly reimbursement.
Your E-mail Address*
Birthdate*

MonthDayYear
Phone Number*
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
Thank you for your request to change your membership to the OhioHealth/YCO Corporate Membership Program. All changes must be submitted 14 days prior to your next monthly membership draft payment. Any changes made within 2 weeks of your next monthly payment will be made the following month.
YMCA You Would Most Frequently Visit*
Need help choosing your closest Y? Check out this map of participating locations.
Member Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please note: Current YMCA members are not charged the enrollment fee. Only new members are charged the $69 enrollment fee.
Choose Membership Option:*

Individual - $18 per pay + no enrollment fee for current Y members (tax included)Household - $32 per pay + no enrollment fee for current Y members (tax included)
Type of Household Membership

Two adult + kids - Includes two adults and their children through the age of 24, sharing the same residence.One Adult + Kids - Includes one adult and their children through the age of 24, sharing the same residence.Two Adults - Includes two adults, sharing same residence.
Is the 2nd adult on membership also an OhioHealth associate who is enrolled in the OhioHealthy Medical Plan or the Opt-In-To Wellness plan
OhioHealth Clock Number for Second Adult
Which OhioHealth clock ID carries the medical plan?
Signature*

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Branch Info
branchemail
Branch Staff
Branchphone
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OhioHealth/YCO Corporate Membership Program