SENIOR COUPLE Membership: Let's Get Started!

Please review the following "Authorization and Payments" information. Then click on the button below to proceed:

Bank Draft Authorization

I hereby authorize the YMCA to initiate debits from the BANK indicated on the provided check for the monthly membership amount specified (please bring a voided check upon your first visit to the facility to setup the monthly payment). The authority is to remain in effect until YMCA has received 10 days written notification from me of the termination of this agreement, or until the YMCA or bank has sent me 10 days written notice of the YMCA’s or bank’s termination of the agreement. The YMCA will send a 10 day notification of any change in the amount to be drafted. Should my membership draft not be honored by my bank for any reason, I realize that I am still responsible for that payment and a second attempt to collect, including a YMCA service charge, will be made prior to my next draft. This is in addition to any service fee my BANK may make.

Verification and Authorization

In accordance with the character values of faith, honesty, respect, caring and responsibility, I/We verify that the information provided on this application is accurate. This includes, but is not limited to, the selection of membership category and covered individuals. I/We further agree to adhere to the rules of the YMCA. If these rules are not followed, I/We agree that the YMCA reserves the right to take necessary disciplinary action, including temporary or permanent suspension of membership and total ban from admittance to use the facility.

By submitting this application, I/We agree that the YMCA may photograph or videotape me/us, and the YMCA may use those photographs or video footage for its marketing purposes. I/We release the YMCA from any claim or liability related to that use, waive all claims for myself/ourselves, my/our heirs and assignees against the individual YMCA staff persons and the Georgia Mountains YMCA, Inc.

I/We agree that the YMCA shall not be responsible for any personal injuries or losses sustained by me/us while on any YMCA premises, or as a result of any YMCA sponsored event. I/We further agree to indemnify and hold harmless the YMCA from any claims or demands arising out of any such claims or losses.

Payment Policies and Authorizations

All payments will be drafted on the 5th or the 20th of each month (you may choose this in the upcoming registration steps). *Non-Refundable joiner fee (if any) must be paid at the time of enrollment. Fees will be collected by automatic bank draft of checking account. (All enrollees will use the auto bank draft or advance payment option). No credits will be given for any family without written approval from the YMCA Directors. Your membership requires a 10 day notice of cancellation. Please complete the change/withdrawal form located at the member service desk to make any changes to your address, enrollment, etc. There will be no exceptions or changes made to any account unless this notice has been received by the YMCA office 10 calendar days in advance.

Non-Payment: Non-payment could result in service fees added to you account, and suspension of your membership until all fees are paid, and current draft information is set up. To avoid these fees please make sure that the YMCA has current and correct bank draft information on file. I understand that if my account is turned over to collections for non-payment, there will be a $30 late fee added on to my account.

Bad Bank Draft, Checks, or Declined Credit Card Fees: Any payments returned for any reason will result in appropriate late fees, plus a YMCA service fee of $30.00 per incident. Notice Clause: “I agree to give a 10 day written notice if I wish to cancel my membership for any reason. If I do not give a 10 day notice I understand that I will be responsible for payment in full. Without 10 days notice the YMCA will hold my space open and I will assume full financial responsibility”.

Payment Clause: “I hereby make assignment of all membership fees to the Georgia Mountains YMCA, Inc. I also, make authorization for the same to release any personal information necessary to execute collection of payments due to the YMCA. I understand that I am personally responsible for all charges to my account, regardless of any reason unless approved and signed by the Professional Directors of the Georgia Mountains YMCA. I guarantee payment in full to the Georgia Mountains YMCA, Inc. for all charges made for membership. I understand that should my account be placed for collection, I will be responsible for all costs including, court cost, collection fees, and attorney fees.”

BY CLICKING THE BUTTON BELOW, I AGREE TO THE TERMS AND AGREEMENTS SHOWN ABOVE: