YMCA at ACRC Membership Application
The YMCA at ACRC will only be honoring the Medicare OnePass program through May 31st 2022 at which time the contract expires. Starting in June, the YMCA will be offering an alternative program for Medicare participants. 
I acknowledge, that the YMCA at ACRC will only offer OnePass through May 2022 at which time I may be required to pay dues and a joiner's fee or participate in an alternative program. * *
I have Medicare *
I am or have been a YMCA Member? *
I am a Veteran? (must provide proof of service) *


Would you like a tour? *


I understand that the YMCA at ACRC requires a minimum of 2 MONTHS of membership paid in full before I can cancel my membership. If my membership dues are paid through credit card or electronic funds transfer, I understand this is a continuous membership plan. I will continue to be charged unless I fill out the Membership Termination form, which can be found on our website, prior to the 26th of the month to stop the next month's bank/credit draft. I understand that Membership dues are drafted on the 1st day of each month. I understand a $15 return fee will be charged for all refused/returned debit cards, credit cards or returned checks for any fees incurred at the YMCA at ACRC in addition to any bank fees associated with the return. I understand that I will be charged membership dues even if I do not utilize the facility and will continue to be charged until I cancel my membership. I understand that all membership rates are subject to change and if and when that happens, I will receive notice four weeks prior to that change. I will then be charged those new rates through my continuous membership plan through my credit card, debit card or electronic funds transfer unless I cancel my membership. I understand it is my responsibility to notify the YMCA of any change in address, bank account information (if utilizing bank draft for payment of dues) or debit/credit card information/expiration date (if utilizing credit card for payment of dues). I understand that the Joiner Fee is a one-time fee as long as I remain an active member of the YMCA at ACRC. If I choose to cancel or discontinue my membership for more than 30 days, a Joining Fee will be charged when I reapply for membership. I understand that canceling my membership will result in forfeiture of any unapplied insurance reimbursement. I understand that membership dues are not subject to refund and that I will be responsible for any outstanding balances before I am able to cancel my membership.

RELEASE OF LIABILITY/PARTICIPATION AGREEMENT: By participating in the YMCA National Membership Program, I agree to release the National Council of Young Men’s Christian Associations of the United States of America, and its independent and autonomous member associations in the United States and Puerto Rico, including without limitation, the YMCA at ACRC from claims of negligence for bodily injury or death in connection with the use of YMCA facilities, services provided by or through YMCA facilitation or the YMCA and from any liability for other claims, including loss of property, to the fullest extent of the law. I understand the YMCA may take photo/video/audio of myself and/or my children and use them in accordance of our media policy.

SEX OFFENDER POLICY: The YMCA conducts regular sex offender screenings on all members, participants, and guests. If a sex offender match occurs, the YMCA reserves the right to cancel membership, end program participation, and remove visitation access. Conduct detrimental to the association and/or in disregard of Y member policies and practices may result in suspension/termination of membership privileges and possible litigation.

CODE OF CONDUCT: The YMCA is committed to providing a safe and welcoming environment for all. To promote safety and wellbeing, the YMCA asks all persons to act appropriately when in our facility, on our property, or participating in our programs.

We expect persons using the YMCA to act maturely, to behave responsibly, and to respect the rights and dignity of others. The actions listed below, which are not intended to be an all-inclusive list of behaviors, are considered inappropriate, and are prohibited in our facilities or programs and may lead to suspension or termination of membership:

Using or possessing alcohol or illegal drugs on YMCA property, in YMCA or facilities, or at YMCA sponsored programs.

Smoking on YMCA property – all YMCA buildings and grounds are smoke-free and tobacco-free environments; this includes e-cigarettes.

Harassment or intimidation by words, gestures, body language, or any type of menacing behavior. The YMCA has zero tolerance for discrimination against any person for their race, religion, gender, or sexual orientation.

Physical contact with another person in an angry, aggressive, or threatening way.

Verbally abusive behavior, including profanity, angry language, swearing, name-calling, or shouting.

Sexually explicit conversation or behavior; any sexual contact with another person.

Inappropriate, immodest, or sexually revealing attire is not allowed. Shirts must be worn over sports bras. Athletic shoes must be worn on wood floors. Proper swimsuits must be worn in pool areas. Appropriate workout/activity attire is always required. No clothing with vulgar language or racial slurs is allowed.

Theft or behavior that results in the destruction or loss of property.

Loitering within facilities or on the grounds of the YMCA after being requested to depart the YMCA’s property.

Carrying or concealing any weapons, devices, or objects that may be used as weapons (including items that appear to be real). The YMCA bans all weapons on premises with or without a permit.

Any willful activity that may result in the harming of the member, guest, or others.

Use of YMCA social networking websites in a manner that is contrary to the YMCA’s mission, is detrimental to the community, or is in violation of the law.

Use of cameras or other picture taking or recording devices is not permitted in the locker rooms.

Taking pictures or video of another person at the YMCA, without their permission and knowledge, is not allowed.

In addition, the YMCA reserves the right to deny access or membership to any person who has been accused or convicted of any crime involving sexual abuse, is or has been a registered sex offender, has ever been convicted of any offense relating to the use, sale, possession, or transportation of narcotics or habit forming and/or dangerous drugs, or is presently or habitually under the influence of dangerous drugs or chemicals, narcotics, or intoxicating beverages. To ensure the safety of our members, the YMCA conducts regular sex offender screenings on all members, participants, and guests.

Anyone who feels that this Code of Conduct is being violated should immediately report the behavior to a Director on duty or front desk personnel.

Suspension or termination of YMCA membership may result from a violation of this Code of Conduct or other YMCA policies. While an incident is being investigated, the membership of the person(s) accused of violating this Code of Conduct may be suspended pending a final decision. Suspension or termination of YMCA membership privileges may result from a decision by the Code of Conduct Committee if they deem a violation has occurred.

By signing this document, I agree to the Membership Agreement, Policies, Code of Conduct and Authorization Agreement *
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YMCA at ACRC • 507.433.1804 • info@ymcaatacrc.org • www.ymcaatacrc.org