Guest Form test - The YMCA of Greater Birmingham: For A Better Us

Guest Form and Waiver

IN TOWN GUESTS ONE Free Guest Visit in a Calendar Year under the following guidelines: 1 - Guest is accompanied by a YMCA member or presents a Guest Pass issued by an authorized YMCA staff member 2 - Guest is age 12 and up and accompanied by a YMCA member age 12 or older 3 - Guests under age 19 must present a Waiver (included on this form) signed by the Guest’s parent or legal guardian 4 - Guest allows sufficient time to be properly checked in through our Member Services Desk and agrees to the following prior to facility use: 5 - Provides valid Photo ID (age 16+) 6 - Is compliant with completing necessary waivers 7 - Is compliant in providing accurate contact information and having photo taken which will be entered and stored on our local database and subject to subsequent sex offender screening | Member is allowed a maximum of 1 individual guest or 1 family unit per visit | Member is responsible for Guest for duration of visit and both are expected to comply with member Terms and Conditions | ONE $25 additional Guest Visit in a Calendar Year: Guests meeting the above conditions that have taken advantage of their Free Initial Guest Visit may visit a 2nd time with a $25 Guest Fee payable by debit/credit card or cash in advance of facility use | OUT OF TOWN GUESTS (OF A MEMBER) Out of town guests of members may visit up to 7 days per calendar year at no charge. Guests must be accompanied by a member during each visit to the Y under the same conditions noted above. “Out of town” is defined as a person living more than 50 miles outside our service area and not a current YMCA member. Members may elect to upgrade their membership for household members residing for an extended stay past 7 days.

Guest Name*
First Last
Date of Visit*
MM slash DD slash YYYY
Guardian Name (for Guests under age 19)*
First Last
Name*
Guest of : (Member's First and Last Name and DOB) *
Email Address of self (age 19 and up) or guardian if under 19*
Phone of self (age 19 and up) or guardian if under 19*
Guest Date of Birth*
MM slash DD slash YYYY
Guest Zip Code*
Branch Visiting*
I (Guest) am age 19 or above*
Please check all that apply
- This is my first visit this year as an In Town Guest
- This is my second visit this year as an In Town Guest ($25 fee)
- I am an Out of Town Guest
- I would like information on Membership
- I am the Guardian of Guest (age 12-18)
Consent*
I consent to the below information of behalf of self/minor
Use of the YMCA of Greater Birmingham (YMCA) facilities and participation in sports or other physically demanding activities inherently exposes the participant to a certain degree of risk of personal injury, illness, and other adverse medical consequences. The YMCA is not an insurer of a members' life or personal safety. No participant will engage in activities which require a level of physical fitness exceeding the participant's physical condition or
abilities, as determined by the participant. Every participant assumes the risk of personal injury, illness or other condition arising out of or related to the participant's activity on YMCA premises.
I agree to release the National Council of Young Men's' Christian Association of the United State of America and its independent and autonomous
member association in the U.S and Puerto Rico from claims of negligence or bodily injury or death in connection with the use of YMCA facilities and from any liability for other claims including loss of property to fullest extent of the law. I give permission to the personnel of the YMCA of Greater Birmingham to video, photograph, make a voice recording or motion picture of me and/or my minor/child/children, to be used in connection with the internet, printed material, visual or auditory presentations, or to use in a depiction of a team activity. Also, these items will be exclusive property of the YMCA of Greater Birmingham.

As a membership organization, our first priority is to our YMCA of Greater Birmingham members who have made a commitment to the Y by Joining. The Guest and Visitor Policy Is designed to accommodate Members wishing to bring
a Guest, and Prospective Members wishing to visit the Y prior to joining. The YMCA of Greater Birmingham reserves the right to deny access to any member or guest who may pose a potential threat to the security and/or safety of members, guests, or participants. We do not sell passes for in town or out of town guests to come alone.
"Individual branches may place seasonal or facility area limits based on facility demands and capacity or during Member Advantage times
Upload of Identification

***********Please upload valid Driver's License of guardian for guests under age 19**********
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Max. file size: 128 MB.
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