Auto Pay Change Form

Please complete the form below to request a change to your credit card or bank account information. Changes to payment method must be made by the 25th of the prior month for the new rate to be effective for the next month’s draft. For example, a change must be submitted by June 25 to be effective for July.

Member Name: *

First

Last

Person Completing Form: *

First

Last

Phone *

Email *

Change Auto Pay

Please select which auto pay you would like to make the changes to.

Select payment method: *

Change Bank Account
Change Credit Card

Please list the last 4 digits of the card/bank account you would like to use for the above auto pay. If the card/account is not currently on file please follow the instructions below. *

Add new payment method:

To add a new payment method you will need to log in to your online account to add a new bank account or credit card. Go to fspymca.org/account and follow the instructions to set up or log into your account and change your payment method. If you have any questions, please email membership@fspymca.org

I understand that my new payment method will be charged on the 1st of each month for the program selected except for Summer Camp, which will be charged on a weekly basis as outlined in our camp brochure. I understand that written notice is required if I need to withdraw my child from the program and/or cancel membership and that program/membership fees are non-refundable. I understand that any changes to my bank account/credit card must be made prior to the draft date to be processed on the updated bank account/credit card. Card Holder please sign by entering your name below: *

Today's Date: *

Change Auto Pay

Add new payment method:

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