You are applying for: YMCA Membership

Your full name

Date of Birth

Family Information

Enter any other members of your family below.

A family membership consists of two adults in the same household, plus dependents. If you wish to add other adults i.e. college students or dependent adults, you will need to provide eligibility proof when you come into the Y. Our membership staff can help you figure this out.

Add New Member

Membership Type

Payment is easy at the Y. Just enter in your Visa, Mastercard or Discover card information and we'll take it from there. Remember that when you join the Y, we will debit your account for your monthly fee on a month-by month basis.


Dependents 18 years and older must be claimed as your tax deduction. Proof may be required. Children ages 10 and older may use the facility without adult supervision. A family is defined by one or two adults and their dependent children living in the same household, all of whom consider themselves a family.

Employer Information

Background

The YMCA strives to provide membership and program services to all who desire to participate. The following questions help us know the people we are serving. Answering these questions is voluntary, but is appreciated.

What activities are you interested in most at the Y?

Please select your top 4 choices.

Personal Information

You are applying for: YMCA Membership

Terms and Conditions

Monthly EFT (Bank changes may take up to 14 days). I hereby authorize the YMCA of Greater Grand Rapids to debit my account indicated below. I understand that the debit will be initiated on the begin date shown below. This authority allows the YMCA of Greater Grand Rapids to debit my account on a month-by-month basis. If I wish to discontinue my membership, the YMCA of Greater Grand Rapids must receive 14 days written notification before my next draft date. Should my bank, for any reason, not honor any debit, I am responsible for the payment, plus a service charge of $25 applied by the YMCA. This is in addition to any fees or penalties I may incur by my bank or financial institution. I understand that this is my responsibility to notify the YMCA in writing should I change financial institutions, get a new credit card, and/or make changes to my account at any time.

Billing Information








Payment Information






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Terms & Conditions