Meridian Senior Center Membership Signup
ENGAGE MEMBERSHIP
Type of registration
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New Member
Renew Membership
How did you hear about us?
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Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Email
*
example@example.com
Date of birth
*
-
Month
-
Day
Year
Date
Are you a veteran?
Yes
No
What Branch Did You Serve In?
Emergency Contact Information
Someone who doesn't live with you, if possible
Emergency Contact Name
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First Name
Last Name
Emergency Contact Relationship to You
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
I WANT TO RECEIVE EMAILS ABOUT TRIPS, EVENTS, ACTIVITIES, AND UPDATES
Yes
I AM INTERESTED IN PARTICIPATING IN THE FOLLOWING ACTIVITES
Art
Bingo
Foot Clinic
Dinners Out
Cards & Games (Pinochle, Bridge, Hand & Foot, Canasta, Farkle, Cribbage, etc.)
Billiards/Pool
Knitting/Looming
Exercise Classes
Dance Classes
Informational Classes
Financial Consultation
Trips and Outings
Support Groups
Legal Consultation
Woodworking
Special Speakers
Bible Study
Other
I AM INTERESTED IN INFORMATION ABOUT VOLUNTEERING IN THE FOLLOWING AREAS
Fundraising
Greeters
Newsletter Delivery
Bingo
Activities
Lobby Host
Dining
Clerical
Teaching a Class
Boutique
Serve on the Board
Center Event Planning
I WOULD LIKE MORE INFORMATION ABOUT THE CENTER'S TRANSPORTATION SERVICES
Yes
Please Read and Initial *Required
Per the Meridian Area Senior Citizens Association, Inc. Bylaws Article 4.4: It shall be the responsibility of each member to act in an appropriate manner; to refrain from obscene and profane language; and to respect the dignity of the members. Failure to do so shall result in disciplinary action and possible loss of membership, as determined by the Association Board. Conditions may be established from time to time by the Board of Directors and recorded in the minutes of the proceedings of the Board of Directors. The Board of Directors, by majority vote, has the sole authority to suspend or expel any member (General or Social) of the Association for violation of Association rules. ***General members live in Ada County. Social members live outside of Ada County or are a spouse under the age of 60 of a General member.
Initial Here
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Please Read and Initial *Required
Any person using any of the services, land, or facilities of Center at the Park/Meridian Senior Center, does so entirely at their own risk, and that Meridian Senior Center/Center at the Park is not liable for any personal injury, illness, personal property loss, or any other condition or effect that results directly or indirectly from use of the facility.
Initial Here
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Please Read and Initial *Required
By entering the Center at the Park/Meridian Senior Center, you are entering an area where photography, audio, and video recording will occur. By entering these premises, you consent to all recording of media and its release, publication, exhibition, and/or reproductions, to be used for any Meridian Senior Center/Center at the Park purpose. You further waive your rights to all claims in connection with any Center at the Park/Meridian Senior Center publication(s), regardless of its purpose.
Initial Here
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Please Read and Initial *Required
Attendance is not mandatory. Membership dues are used solely for operation and maintenance of Center at the Park/Meridian Senior Center.
Initial Here
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Your Electronic Signature *Required
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Today's Date
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-
Month
-
Day
Year
Date
Age Verification *Verify you are over 60 years of age
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Yes
No
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