[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-282016-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-282016-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","winona-family-ymca-membership-agreement-fillable","Winona Family YMCA Membership Agreement - Fillable","","Winona Family YMCA membership agreement collects member and family details, including primary and optional second adult information, emergency contacts, and dependent listings. It defines membership categories (youth, young adult, adult, one/two adult family, older adult) and optional additional services such as locker, towel, 24/7 access, and coffee with fees. It specifies membership conditions, cancellation and hold procedures, rate change notice, liability rules, transfer restrictions, and safety policies governing equipment and media permissions.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/winona-family-ymca-membership-agreement-fillable/282016/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/winona-family-ymca-membership-agreement-fillable/282016.png","ImageObject",442,249,{"name":42,"@type":43},"Emma Wilson","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-16",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information does the agreement collect from the primary member?","Question",{"text":63,"@type":64},"It requests the primary member’s name, address, phone numbers, date of birth, gender, email, and emergency contact details.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does a member cancel or place membership on hold?",{"text":68,"@type":64},"To terminate a membership, a Cancellation Form must be given by the 20th of the prior month. Memberships can be placed on hold for up to 6 months if the Hold Form is received by the 20th before the next draft date.",{"name":70,"@type":61,"acceptedAnswer":71},"What liability and permission terms are included?",{"text":72,"@type":64},"The agreement includes a liability & indemnity waiver for use of YMCA facilities and programs and includes permission for the YMCA to use photos, videos, or other media that may include the member’s image or voice to promote YMCA programs.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},282016,1790298603,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":22,"preview_page_count":4},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Winona Family YMCA Membership Agreement  \n1. Primary member name-18 or older (first, middle, last)   Address (include city, state, zip)   Home phone (  )   Cell phone (  )   Date of birth  / /  Gender   Email   Emergency contact name   Emergency contact phone    \n2. Second adult name- (For 2 Adult Family memberships)  Home phone (  )   Cell phone (  )   Date of birth  / /  Gender   Email    \n\n| Member | Name of dependents in household- 23 and under (first, middle, last) | Gender | Date of birth |\n| --- | --- | --- | --- |\n| 3. |  |  |  |\n| 4. |  |  |  |\n| 5. |  |  |  |\n\n\n| Membership Type | Standard\u003Cbr>Membership | Corporate\u003Cbr>Membership\u003Cbr>(Document\u003Cbr>Employer Name) | Insurance-based Membership\u003Cbr>(Document Program Name) |\n| --- | --- | --- | --- |\n| Youth\u003Cbr>(17 or younger) | ▢ |  |  |\n| Young Adult (18-25 years) | ▢ |  |  |\n| Adult\u003Cbr>(26-61 years) | ▢ |  |  |\n| One Adult Family | ▢ |  |  |\n| Two Adult Family | ▢ |  |  |\n| Older Adult (62 and wiser) | ▢ |  |  |\n\n\n| Additional\u003Cbr>Services to Add | Add\u003Cbr>for me | Add for\u003Cbr>unit |\n| --- | --- | --- |\n| Locker- $10/mo per person (18+ only) | ▢ | ▢ |\n| Towel - $12/mo per person | ▢ | ▢ |\n| 24/7- $10/mo/person,$20/mo/unit\u003Cbr>(Must be 16+, 16-17 must be with adult with 24/7 access at all times) | ▢ | ▢ |\n| Coffee- $6/mo per person | ▢ | ▢ |\n\nConditions of membership  \nMembers are required to present a valid membership card/identification when using the Y. A photo ID is required to set up a membership for anyone over the age of 18 . To terminate a membership members must give the YMCA a Cancellation Form by the 20th of the month prior, or will be held responsible for a full month’s payment. For a $10/mo fee, memberships can be placed on “hold” for a max of 6 months during which time no membership dues will be drafted. To place a membership on hold,  Hold Form must be received by the 20th of the month prior to the next draft date. The Winona Family YMCA reserves the right to increase membership rates. Electronic notice of membership rate changes will be communicated via electronic newsletter and website at least 30 days in advance. The Winona Family YMCA is not responsible for personal property lost, damaged or stolen while using the Winona Family YMCA facilities or participating in YMCA programs. For the safety and security of the Winona Family YMCA members and guests, any and all video equipment, including cell phones, may not be used in locker rooms or restrooms. I give permission for the Winona Family YMCA (local, national and international) to use, without limitation or obligation, photographs, videos, or other media that may include the member’s image or voice to promote the YMCA and its programs. Membership to the Y is a privilege, and the Y reserves the right to cancel a membership at any time as deemed necessary. Membership privileges and cards are not transferable. Members or participants with a balance noted on their account can not rejoin, use the facility, or participate in programs until it is paid, or a payment plan is established. This does not apply to youth 17 and under paying for a day pass. Since it is contrary to the mission of the YMCA to be a sex offender, the YMCA will deny or revoke a membership to such a person. A no-tolerance stance will be taken on all sex offenders.  \nAcceptance I accept all provisions of membership set forth above and understanding the mission of the Y, hereby agree to a membership. I understand information given to my Y is the property of the YMCA and is kept as confidential information by the Y and its representatives. I agree to the terms and conditions set forth in the membership handbook and agree to abide by the mission and core values of the YMCA.  \n  I have read and understand the Winona Family YMCA's Conditions of Membership.  \nInitial  \n  I will familiarize myself with the Winona Family YMCA'[s Code of Conduct](s Code of Conduct winonaymca.org/policies)[ winonaymca.org/policies](s Code of Conduct winonaymca.org/policies). ","cbCaifIO6HKN3ltX","https://ap.wps.com/l/cbCaifIO6HKN3ltX","pdf",130232,"English","# Primary member information\n## Second adult (two adult family)\n## Dependents in household\n# Membership type selection\n## Additional services\n# Conditions of membership\n## Cancellation, hold, and rate changes\n## Safety, media permission, and privileges\n# Acceptance and initial certifications\n# Liability & indemnity waiver","[{\"question\":\"What information does the agreement collect from the primary member?\",\"answer\":\"It requests the primary member’s name, address, phone numbers, date of birth, gender, email, and emergency contact details.\"},{\"question\":\"How does a member cancel or place membership on hold?\",\"answer\":\"To terminate a membership, a Cancellation Form must be given by the 20th of the prior month. Memberships can be placed on hold for up to 6 months if the Hold Form is received by the 20th before the next draft date.\"},{\"question\":\"What liability and permission terms are included?\",\"answer\":\"The agreement includes a liability \\u0026 indemnity waiver for use of YMCA facilities and programs and includes permission for the YMCA to use photos, videos, or other media that may include the member’s image or voice to promote YMCA programs.\"}]","Winona Family YMCA Membership Agreement - Fillable | PDF",1789569640]