Guest Waiver - Minors - The YMCA of Greater Birmingham: For A Better Us

Guest Form and Waiver

To be completed by the parents or guardians of minors accompanying a member without their parent/guardian present.

* Indicates required field

Date of Visit*

Guest Name*

First Middle Last

Address*

Street Address City State ZIP Code

Guest Date of Birth*

I (Guest) am age 19 or above*

For Family Guest Visits | Please list name and DOB of each Family Member (do not need separate from for each Family member)

Guardian Name (for Guests under age 19)

First Last

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*

Hosting Member Name*

First Last

Hosting Member Birthdate*

Branch Visiting*

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.

All individuals age 18 and older receive a Screening against a National Registered Sex Offender database. Confirmed matches will be denied access to the YMCA of Greater Birmingham.

Identification Files*

Max. file size: 128 MB.

Please upload valid Driver's License of self (19 and up) or guardian for guests under age 19

Message

Guest Waiver - Minors

Guest Form and Waiver

Find your
fitness at
the Y

Find your
friends at
the Y

YMCA of Greater Birmingham

Guest Waiver - Minors

Guest Form and Waiver

Find your fitness at the Y

Find your friends at the Y

YMCA of Greater Birmingham

Find your
fitness at
the Y

Find your
friends at
the Y