The YMCA is committed to serving people of all ages, races, religions and economic levels. By answering the following questions, you will help us meet this goal. This information will be kept confidential. Thank you.
Waiver
I am an adult over 18 years of age and wish to participate in the YMCA of Pueblo (the “YMCA”) membership/program activities, and (if dependents portion is filled out on the front of this application), wish my children or legal wards to participate and give them permission to participate in the YMCA activities. As used in this Agreement “children” shall include legal wards and “parent” shall include legal guardian. As a condition to being permitted to utilize the facilities, services, and programs of the YMCA for any purpose, including but not limited to observation or use of the facilities or equipment, or participation in any off-site program affiliated with the YMCA. I, the undersigned, acknowledge, agree, and represent that I have inspected and carefully considered the facilities and programs. I understand that even when every reasonable precaution is taken, accidents can happen.
As a condition to participation by me or my children in YMCA activities, on my behalf and on behalf of my children, I waive and release any claims for loss or injury incurred or suffered which I or my children might make against the YMCA, its sponsors, officers, employees, volunteers, or contractors as a result of participating in YMCA activities or using its facilities. I further agree to indemnify the YMCA against and hold it harmless from loss incurred as a result of claims against it based upon alleged actions or omissions by me or my children. I have read this authorization waiver, and release, understand it and am voluntarily signing it.
I understand that the YMCA is not responsible for personal property lost damaged, or stolen while members and I or program participants are using YMCA facilities on YMCA premises, or involved in YMCA programs.
I give my permission to the YMCA to use without limitation or obligation, photographs, film footage, or tape recordings which may include my or my children’s image or voice for the purposes of promotion or interpreting YMCA programs.
Membership Agreement
If my membership dues are paid through Credit Card draft of Electronic Funds Transfer, I understand this is a continuous membership plan. This membership will remain in effect for as long as I retain the membership card issued to me. Membership cards are the property of the YMCA and must be surrendered upon demand.
It is my complete understanding that if I wish to terminate or change my membership in any way, I must give the YMCA a 30 day written notice.
All membership rates are subject to change with 30 days written notice. I understand it is my responsibility to notify the YMCA of any change in address, bank account information (if utilizing bank draft for payment of dues) or credit card information / expiration date (if utilizing credit card for payment of dues).
The Joiners Fee is a one-time fee as long as you remain an active member of the YMCA of Pueblo. If you choose to cancel or discontinue your membership for more than 30 days, a Joiners Fee will be charged when you reapply for membership.
$20.00 NSF fee is applied to every returned transaction. The YMCA reserves the right to collect those fees before access to the facility.
I acknowledge the waiver and membership agreement set forth above, and being in sympathy with the Mission Statement of the YMCA of Pueblo, hereby apply for membership.
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