Thank you for showing interest in joining our YMCA community! We are excited to have you join our YMCA family. Please complete the application below, so the YMCA staff can process your membership application. Membership applications take 24-48 hours from the time this form is completed to be processed. You will receive an email from our Member Engagement Team when your application has been processed and we are ready for you to visit the Y with the following items:

Picture ID (18+), minors activating a youth membership need to come with an adult who brings their picture ID for activation purposes.
Method of Payment
Be prepared to have your picture taken

Welcome to the Y! We look forward to seeing you soon!

I am a Veteran? (must provide proof of service) *

Yes

No

I am a college student? (must provide proof of current course enrollment) *

Yes

No

I am a semi-pro or amateur athlete? (must provide proof of current roster) *

Yes

No

Are you interested in scheduling a new member orientation with our Healthy Living Director? *

MEMBERSHIP TYPE

Please select Membership Type *

Membership Type	Rate	Joining Fee
Adult (26yrs+)	$61/mo.	$50
Family*	$76/mo.	$50
Senior (65yrs+)	$39/mo.	$50
Senior Couple (65yrs+)	$55/mo.	$50
Young Adult (19 – 25yrs)	$39/mo.	$50
Youth (14 – 18yrs)	$13/mo.	$0
Student/Athlete*	$10/mo. off	$0

MEMBERSHIP ADD-ONS

I would like to rent a locker at the YMCA? (Men/Women Full Locker $12/mo., Men/Women Half Locker $6/mo., Outer Bank Half Locker $6/mo.) *

Yes

No

Child Watch add-on, $25/mo. unlimited Child Watch. (Unlimited children- 90-minute max daily)
*

Yes

No

PRIMARY MEMBER CONTACT INFORMATION

Please fill in the contact information for the Primary person on the Membership. If applying for youth, for example, the Youth will be the Primary person.

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

D.O.B. * +

Gender *

Race *

Emergency Contact Name (first, last) *

Emergency Contact Phone Number *

Emergency contact email address *

Place of Employment

I am between the ages of 14-18. I understand that I must provide proof of age.

Yes

Parent/Guardian email address *

Parent D.O.B. * +

CO-MEMBER CONTACT INFORMATION (if applicable)

Please specify the 2nd adult on the Membership (if applicable)

First Name

Last Name

Phone Number

Email Address

D.O.B. +

Gender

Race

Emergency Contact Name (first, last)

Emergency Contact Phone Number