Metuchen Edison YMCA  Woodbridge Branch
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YMCA Outdoor Pools
Woodbridge Branch YMCA Outdoor Pools
2010 Online Registration

Please fill out all information as completely and accurately as possible. All fields marked with * are required.

  
*Membership Type:
Adult Name
*First:
*Last:
Adult Name
First:
Last:
*Address:
*City: *State: *Zip:
*Home Phone: Work Phone:
Child/s Name:
1.
2. 2.
3. 3.
4. 4.

Payment

Payment can be made via check or credit card (Visa, MasterCard or American Express. If you pay by check, your registration will not be processed until the check is received.

I/we do hereby apply for membership in the Woodbridge Branch YMCA Pool and its facilities and hereby agree to abide by all regulations of the pool. Falsification of any part of this application will result in the loss of my/our membership and forfeiture of all monies paid. Proof of residency and/or age may be required at the discretion of YMCA management. After May 15, deposit and/or balance is non-refundable and unable to be credited. I give permission for my and/or my family’s picture to be taken or used in any YMCA promotional materials. I understand that if I do not wish to have pictures taken or used by the YMCA, I must notify the branch director in writing. There is a $35 service charge for returned checks.

Name on Card:
Card: Card Number: Exp. Date (mm/yy):
Please charge my credit card for a deposit of   $
Please charge my credit card on May 15 for balance due

Additional Comments:
 

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