YMCA of the Rockies Membership Application

Membership includes you, a spouse/partner, any dependent children you have, and any related family members living in your household.

Member Number (if available)

First Name *

Last Name *

Email *

Date of Birth *

Street Address

City

State

ZIP Code

Cell Phone *

Home Phone (if different from cell)

Do you have a spouse/partner living in your household? Yes No

All ADULTS (18 years and older) must be screened through the National Sex Offender Registry.
Anyone who is on the National Sex Offender Registry list is immediately denied membership and is denied access to YMCA property and programs.

Spouse/Partner First Name

Spouse/Partner Last Name

Spouse/Partner Date of Birth

Do you have an additional ADULT who is 18 or older AND lives in YOUR household? Yes No

Additional Adult First Name

Additional Adult Last Name

Additional Adult Date of Birth

Relationship of the Adult

Do you have an additional ADULT 2 who is 18 or older AND lives in YOUR household? Yes No

Additional Adult First Name

Additional Adult Last Name

Additional Adult Date of Birth

Relationship of the Adult

Please check here if you use the Nordic Center at Snow Mountain Ranch Yes, I use the Nordic Center

How do you want to receive your membership card? Email Only Postal Mail Only Email and Postal Mail

What is your primary reason for becoming a member? Priority booking Programs/facilities Nordic Center Other

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