Membership Pre-Registration Form | www.ytools.net

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Membership Pre-Registration Form

Welcome, and thank you for considering joining the YMCA of Western Ontario.

To speed up your membership registration, please use this form to pre-register prior to coming in to one of our fitness centres to complete your registration.

If you have any questions about your membership, please contact us.

Member Information

Last Name: *

First Name: *

Home Phone: *

Email: *

Birth Date: *

Gender: *

Male

Female

Emergency Contact

Name: *

Phone: *