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YMCA Arlington Tennis & Squash Center

Pickleball Only Membership Application

The mission of the YMCA of Metropolitan Washington is to foster the spiritual, mental and physical development of individuals, families and communities according to the ideals of inclusiveness, equality and mutual respect for all.

Thank you for choosing to join the YMCA! 

MISSION

I understand that the YMCA of Metropolitan Washington is a non-profit charity with a mission to foster the spiritual, mental & physical development of individuals, families and communities according to the ideals of inclusiveness, equality and mutual respect for all. 

I Agree

 

CONDITIONS OF MEMBERSHIP

I understand that all members are required to present a valid membership card for identification when using YMCA facilities and/or participating in programs. If for any reason members are unable to present membership cards, they are required to present photo identification. Membership cards are not transferable; remain the property of the YMCA; and must be returned to the YMCA upon request. 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. Monthly membership drafts continue indefinitely unless members provide written notice of cancellation, or the YMCA terminates the membership. Annual memberships must be renewed.

I Agree
 

I understand that I (and all individuals that are included in this membership application) will be automatically transferred into a new membership category on my/their birthday, if eligible, in which event dues may increase or decrease. In the event of any other qualifying event that changes the category of membership for which I am / we are eligible, I agree to notify the YMCA on or before the first day of the month following the month in which such event occurs.

I Agree

 

LIABILITY WAIVER

My signature acknowledges that I understand the YMCA of Metropolitan Washington assumes no responsibility for injuries or illnesses which I, my spouse/partner, or my minor children or any other person may sustain as a result of my/their physical condition, this membership, my/their use of an facility or my/their participation in any activities, programs, exercise, or the use of any equipment (collectively, “Activities”). I expressly acknowledge on behalf of myself, my spouse/partner, my minor children and our heirs that I assume the risk for any and all injuries, illnesses, death, loss or damage which may result from any of the foregoing. I hereby release and discharge the YMCA of Metropolitan Washington, its agents, servants, and employees from any and all claims for injury, illness, death, loss or damage which I, my spouse/partner, or minor children may suffer as a result of my/their physical condition, this membership, the use of any facility or participation in any Activities. In the event I, my spouse/partner or minor children bring any guest to the YMCA of Metropolitan Washington facility or Activity, I also agree to be responsible for ensuring that such guests adhere to the rules and policies of the YMCA and to inform them that they assume all liability for injuries, illness, death, loss or damage which may result from participation in any activities, programs, exercise or the use of any equipment. By participating in the YMCA Nationwide 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, from claims of negligence for bodily injury or death in connection with the use of YMCA facilities, and from any liability for other claims, including loss of property, to the fullest extent of the law. Additionally, I understand that the YMCA of Metropolitan Washington is not responsible for personal property lost or stolen while members and/or program participants are using YMCA facilities or are on YMCA premises.

 

ACKNOWLEDGEMENT

My signature acknowledges that I understand and agree on behalf of myself and all individuals included on this membership that :

  • I have been informed of the location of the YMCA of Metropolitan Washington's Membership Handbook on the YMCA of Metropolitan Washington website (https://www.ymcadc.org/membership-handbook/), and I agree to observe the YMCA's policies and procedures as outlined in the Membership Handbook and as they may be amended from time to time. I reserve the right to request and receive an explanation for any provision of the Membership Handbook that I do not understand.
  • I have been informed that the YMCA Arlington Tennis & Squash Center web page (https://www.ymcadc.org/locations/ymca-arlington-tennis-squash-center/) provides access to the facility's Membership Guidelines, hours of operation, court reservation services, and related imporant information that will be updated and amended from time to time.  I reserve the right to request and receive an explanation for any content that I do not understand.
  • I understand that I am responsible for reading and complying with notices that are posted or sent to my attention.
  • I have been made aware of the YMCA of Metropolitan Washington's COVID19 Code of Conduct, which is available online at https://www.ymcadc.org/covid19-code-of-conduct/ and that I agree to observe the YMCA's policies and procedures as outlined on this page and as they may be amended from time to time. I also understand that I am responsible for reading and complying with related notices that are posted or sent to my attention.

 

 

MARKETING RELEASE

I understand that the YMCA of Metropolitan Washington may take pictures or record videos of members and non-members participating in YMCA programs, using YMCA facilities, or attending YMCA special events. Additionally, I understand that the YMCA may permit members of the media to take such pictures or record such videos in order to promote the YMCA‘s charitable mission and for other journalistic purposes. Signing this membership application (if the person named below is under age 18, a parent or guardian of such person must sign on such person’s behalf) releases the YMCA and the media to use such photographs, video recordings, and/or sound recordings of me and all individuals included on this membership for any purpose consistent with the YMCA’s charitable mission. I understand and agree to the related Marketing policy outlined in the YMCA of Metropolitan Washington Membership Handbook, which states that I am waiving any and all rights that may preclude the YMCA’s or the media’s use of the pictures or recordings as described above, that I acknowledge that neither the YMCA nor the media has any obligation to use any recordings of me (and all individuals included on this membership), and that I/we will receive no monetary payment or other compensation in exchange for the rights to use pictures or recordings of me/us. 

I Agree

 

MEMBERSHIP CANCELLATION, HOLD AND REFUND REQUESTS

For month-to-month memberships only

Cancellation Requests. I understand that members that wish to cancel their membership must complete a Membership Cancellation Form (available at https://ymcadc.org/myaccount/) one-month in advance of their monthly draft or billing date in order to avoid paying for the next month’s membership dues.

  • For membership payments on the 26th, membership cancellation forms must be completed by the 26th of the prior month.
  • For membership payments on the 10th, membership cancellation forms must be completed by the 10th of the prior month.

 As an alternative for members that do not have internet access, notification to the Y may be submitted via a letter of cancellation to the YMCA branch that the member joined (“Attention: Membership Director”) via U.S. mail. Letters of cancellation must include the member’s full name, membership ID number and complete contact information (mailing address, phone number and email address). For information, please contact member.service@ymcadc.org.

Hold Requests. I understand that:

  • The full details for the Standard Leave of Absence, Medical Leave of Absence, and Military Leave of Absence can be found in the Membership Handbook at www.ymcadc.org/membership-handbook. 
  • To place a membership on hold, members must complete a Leave of Absence Request Form online at www.ymcadc.org/myaccount at least two weeks (14-days) prior to their next draft or billing date, to include their full name, membership ID number, complete contact information (mailing address, phone number and email address), the name of the home YMCA branch, and the reason for their membership hold request. If a Medical Leave of Absence or Military Leave of Absence has been selected, supporting documentation must be sent to member.service@ymcadc.org.
  • Once a membership is placed on hold, members are not permitted to use YMCA facilities (this includes with a guest pass). If member access records reflect your use of YMCA facilities while your membership is on hold, your membership will be reactivated and your account charged. 
  • Members that place their membership on hold by completing a Standard Leave of Absence Request Form will pay a monthly inactive fee of $10/month for an individual / one-adult membership and $15/month for a family / two-adult membership until membership is reactivated or cancelled by the member.  Membership payments automatically resume once the selected hold period has ended. During a Standard Leave of Absence, in the event that a YMCA branch closes for a full month in compliance with a government mandate or health official requirement, members have the option of donating their membership inactive fees to the YMCA or receiving a credit that can be applied towards a future membership dues payment for each full month that the Y was closed. No credits will be issued for partial month closure.
  • To reactivate membership ahead of the end of the hold period, please notify the YMCA via email at member.service@ymcadc.org.  To resume membership access at the end of a Medical Leave, the member must first present a medical clearance letter from their physician to the YMCA (either via email to member.service@ymcadc.org or to a Y staff member at the branch member service desk).

The YMCA reserves the right to change the membership cancellation and the membership leave of absence policies, which will be updated as applicable at www.ymcadc.org/membership-handbook. 

Refund Requests. I understand that refunds and/or credits will not be issued for non-usage of membership or infrequent program participation or facility access. In the event that a YMCA branch closes for a full month in compliance with a government mandate or health official requirement, members have the option of donating the corresponding portion of their membership dues payment to the YMCA or receiving a credit for each full month that the Y was closed. No credits will be issued for partial month closure.

I Agree

 

ACCEPTANCE

On my behalf and for all individuals included on this membership, I acknowledge the WAIVER and CONDITIONS OF MEMBERSHIP set forth above and in the Membership Handbook, and, being in agreement with the Mission and Goals of the YMCA of Metropolitan Washington, hereby apply for the Pickleball-Only Membership to the YMCA Arlington Tennis & Squash Center.

I Agree



Please select who will be joining...
AdultMinorAdult and a Minor
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First Member Name

First Name*

Last Name*

Phone*
First Member Date of Birth*
First Member Information

Gender Identification
Please select your Pickleball Only membership category for the YMCA Arlington Tennis & Squash Center.*
Junior (one individual under the age of 18 years old)
Adult (one individual 18 - 64 years old)
Senior (one individual that is at least 65 years old)
Family (two individuals in the same household with or without children)
How did you hear about the Y?*
First Member Signature*
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Employment

Employer (If not applicable, enter N/A) *

Employer Phone Number *

Occupation *
GOALS & INTERESTS
Personal Goals (check all that apply) *
Improve overall health
Increase social/family time
Play competitive Pickleball
Play competitive Tennis
Weight reduction/managment
Reduce or manage stress
Other
Wellness Interests (check all the apply)
Blood Pressure Management
Diabetes Prevention
Nutrition Counseling with a Registered Dietitian
Personal Training
Pickleball
Tennis
PHYSICAL ACTIVITY READINESS QUESTIONNAIRE

Regular physical activity is fun and healthy. For your safety, please carefully read and respond to all questions. 

1. Has your doctor ever said that you have a heart condition and that you should only do physical exercise recommended by a doctor?*
No
Yes
2. Do you feel pain in your chest when you take part in physical activity?*
No
Yes
3. In the past month, have you had chest pain when not taking part in physical activity?*
No
Yes
4. Do you ever lose your balance because of dizziness or do you ever lose consciousness?*
No
Yes
5. Do you have a bone or joint problem that could be adversely affected by physical activity?*
No
Yes
6. Is your doctor currently prescribing drugs for your blood pressure or heart condition?*
No
Yes
7. Do you know of any reason why you should not take part in physical activity?*
No
Yes

If you answered yes to any of the questions above, please talk with your doctor before you become physically active and provide the YMCA with medical clearance prior to beginning use of the YMCA. 

Friends of the Y

If you are friends with a current member that encouraged you to join the YMCA, please enter their full first name and last name here. We'd like to express our thanks to them for referring you to the YMCA and joining the YMCA family.
Membership Payment
The membership enrollment fee and the monthly membership dues payment have been presented and explained to me. To get started today, I will make a pro-rated membership dues payment for the remainder of the first month of membership at the YMCA in addition to the enrollment fee amount that was presented to me for the membership type and category that I have selected.*
I agree and understand the membership information presented to me. I am ready to join the YMCA.
I do not understand and/or need assistance. Please contact me.
The full details about YMCA membership (policies, fees, payments, etc.) are outlined in the membership handbook, which is subject to change, and is accessible on the YMCA website at www.ymcadc.org.*
I understand and agree.
I do not understand. Please contact me.
Please indicate your preferred method of monthly payment.*
I choose to pay through a bank draft.
I choose to pay through a credit card.
Please select the date of your membership payments.*
I would like to pay my monthly membership dues on the 10th of each month.
I would like to pay my monthly membership dues on the 26th of each month.
Community Support
YMCA members can directly support their community as a volunteer through a wide variety of impactful programs, services and opportunities.*
I'd like to learn more. Please contact me
I'm not interested at this time.
YMCA members have the opportunity to support the Y's work as donors.*
I would like to make a recurring monthly donation to the YMCA. Please contact me.
I am not interested at this time.
Family Membership Details

Complete this section only if you are enrolling in a membership for two individuals or a family with children. For an individual membership, please skip this section.


ADDITIONAL ADULT.  Please list the full name, date of birth (MM/DD/YYYY), gender identity, and email address of one adult that lives in your household that will be joining with you.


Adult's Full Name

Adult's Date of Birth (MM/DD/YYYY)

Adult's Gender Identity

Adult's Email Address

CHILDREN. Please list the full names, dates of birth, gender identities, and email addresses (as applicable) for each child in your household under the age of 18 years old who will be joining your membership with you. The email address is used to create an account in Court Reserve for scheduling program participation. 



First Child's Full Name

First Child's Date of Birth (MM/DD/YYYY)

First Child's Gender Identity

First Child's Email Address (as applicable)

Second Child's Full Name

Second Child's Date of Birth (MM/DD/YYYY)

Second Child's Gender Identity

Second Child's Email Address

Third Child's Full Name

Third Child's Date of Birth (MM/DD/YYYY)

Third Child's Gender Identity

Third Child's Email Address (as applicable)

Fourth Child's Full Name

Fourth Child's Date of Birth (MM/DD/YYYY)

Fourth Child's Gender Identity

Fourth Child's Email Address (as applicable)
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Gender Identification
Please select your Pickleball Only membership category for the YMCA Arlington Tennis & Squash Center.*
Junior (one individual under the age of 18 years old)
Adult (one individual 18 - 64 years old)
Senior (one individual that is at least 65 years old)
Family (two individuals in the same household with or without children)
How did you hear about the Y?*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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