Clearbrook Membership Add-On Application 2024

Primary First and Last Name*

Date of Birth MMDDYYYY*

Date

Email Address*

example@example.com

Preferred language

Address*

Street Address

Street Address Line 2

CityTownState

Zip Code

Primary Member Phone*

of People on your Membership

Select your current membership level and Clearbrook membership choice:*

Active Family Membership - Full Summer $350Active Family Membership - First Half Summer $190- 5/25-7/19*Active Family Membership - Second Half Summer $190 - 7/20-9/2Active Adult Membership - Full Summer $560Active Adult Membership - First Half Summer $335 - 5/25-6/19*Active Adult Membership - Second Half Summer $335 - 7/20 - 9/2Active Youth / Teen Membership - Full Summer $728Active Youth / Teen Membership - First Half Summer $408 - 5/25 - 7/19*Active Youth / Teen Membership - Second Half Summer $408 - 7/20-9/2

*Weekends only from 5/25 - 6/15.

Memberships pertain to Framingham Branch. Does not include Hopkinton Memberships. Add Clearbrook to your current membership and enjoy all Framingham and Clearbrook benefits for you and your family. Up to 2 adults and any number of dependents under 26 living in the same household. Full Payment is due upon registration - YMCA Financial Assistance is available. Cancellations Must be made within 3 business days of membership sign up for full refund.

The MetroWest YMCA is committed to providing a safe and welcoming environment for all members and guests. To promote safety and comfort for all, we ask individuals to act appropriately at all times when they are in our facility or participating in our programs. We expect persons using the YMCA to behave in a mature and responsible way, and to respect the rights and dignity of others. Our Code of Conduct does not permit language or any action that can hurt or frighten another person, or that falls below a generally accepted standard of conduct.

Prohibited actions specifically include: Inappropriate attire. Appropriate attire must be worn at all times. Angry or vulgar language, including swearing, name-calling or shouting. Physical contact with another person in any angry or threatening way. Any demonstration of sexual activity or sexual contact with another person. Harassment or intimidation by words, gestures, body language or any menacing behavior. Theft or behavior that results in the destruction of property. Carrying or concealing any weapons or devices or objects that may be used as weapons. Using or possessing illegal chemicals or alcohol on YMCA property, in YMCA vehicles, or at YMCA sponsored programs. Any other conduct of an inappropriate, threatening or offensive nature. Loitering is not permitted in or outside the YMCA. Smoking is not permitted in or outside the YMCA. The YMCA and its property is a smoke-free environment. Cell phone use, including texting, is prohibited except for in designated areas. The use of audio, camera, and video recording devices is prohibited in all MetroWest YMCA facilities. Those wishing to use audio, camera or video recording devices must receive written consent in advance from a designated YMCA Director. Allowing or assisting unauthorized person(s) access to the facility is prohibited.

Members and guests are encouraged to be responsible for their personal comfort and safety, and to ask any person whose behavior threatens their comfort to refrain in a courteous and respectful manner. If a member or guest feels uncomfortable in speaking with the person directly, they should report the behavior to a staff person or the Building Supervisor on duty. YMCA staff members are eager to be of assistance. Members and guests should not hesitate to notify a staff member if assistance is needed. In order to be able to carry out these policies, we ask that members and guests identify themselves to staff when asked. The Branch Executive will investigate all reported incidents. Suspension or termination of YMCA membership privileges may result from a determination by the Branch Executive if in his/her discretion a violation of the YMCA Member Code of Conduct has occurred. By participating in the YMCA Nationwide Membership Program, I agree to release the National Council of Young Men's Christian Associations of the United States of America, and its independent and autonomous member associations in the United States and Puerto Rico, from claims of negligence for bodily injury or death in connection with the use of YMCA facilities, and from any liability for other claims, including loss of property, to the fullest extent of the law.

I understand the YMCA is dedicated to the development of all people regardless of age, gender, religion, income or ability. I also understand that our programs, services and facilities are designed to enhance the spiritual, mental, physical and social quality of life for our families, our communities and ourselves. I hereby certify that to the best of my knowledge my family and I are in normal health and capable of safe participation at the MetroWest

YMCA. My family and I hold the YMCA harmless for all injuries, property damage, theft and lost or stolen articles incidental to the use of the YMCA facility including, but not limited to, physical activities in which my family and I engage. I also understand that the YMCA reserves the right to revoke memberships. I acknowledge that the YMCA conducts regular sex offender screenings on all members, participants, and guests. If a sex offender match occurs, the YMCA reserves the right to cancel membership, end program participation, and remove visitation access. I give my permission for the MetroWest YMCA to take photographs/videos of myself/my child while involved in the daily activities of the YMCA programs or special events. I understand that these photographs/ videos may be used for media purposes or in MetroWest YMCA videos, newsletter brochures, website, and other promotional vehicles.

I have read the Code of Conduct and waiver and my signature below is my agreement to comply with all parameters set forth above.

I authorize the YMCA to process payment for my membership selection using the card on file.*

YesNo

Signature*