Free Community Center Membership Form Template

Community Center Membership Form

Please complete the following form to become a member.

Personal Information

Name

    Date of Birth

      Email

        Phone Number

          Address

            Membership Type

              • Individual

              • Family

              • Senior (Age 55+)

              Emergency Contact Information

              Name

                Relationship

                  Phone number

                    Interests (Optional)

                    Select all that apply

                      • Fitness Classes

                      • Social Events

                      • Arts & Crafts

                      • Educational Workshops

                      • Volunteering Opportunities

                      By signing below, you agree to abide by the center’s guidelines and policies.

                      Name:

                      Date:

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