Community Center Membership Form
Community Center Membership Form
Please complete the following form to become a member.
Personal Information
Name
Date of Birth
Phone Number
Address
Membership Type
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Individual
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Family
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Senior (Age 55+)
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Emergency Contact Information
Name
Relationship
Phone number
Interests (Optional)
Select all that apply
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Fitness Classes
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Social Events
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Arts & Crafts
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Educational Workshops
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Volunteering Opportunities
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By signing below, you agree to abide by the center’s guidelines and policies.
Name:
Date:
Thank you for joining our community!
We appreciate you taking the time to submit.
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