Assisted Membership – Option 2 Form

Option 2 (For Individual and Family Memberships)

Assisted Membership Application / Renewal Form

Application for members to access subsidized membership rates through our Shape Your Future community donors.

Family Application
Requires income verification via tax returns and 1 month of pay stubs from all adults on the application.

Full Name

Birth Date

Phone Number

Email Address

Mailing Address

Emergency Contact Full Name

Emergency Contact Phone Number

Do you have additional family members on this application?
(All additional family members must reside in the same household)

Yes No

Enter Full Names and Birthdays of the additional family members below (if applicable.)

Choose a Membership Type

Assisted Drop-In Membership Assisted Monthly Membership

Please upload all files required for your Option 2 application, including most recent Notice of Assessment and 1 month of pay stubs for all applicants over the age of 18 on the application (JPEG preferred).
Please upload all files at the same time, uploading each file individually results in an error.

Additional details/comments:

At the YMCA of Lethbridge, we respect and protect your privacy. With your consent, we will gather only the minimum personal information necessary to register you and your families in our programs and to provide you with appropriate information about our programs and services. We will not sell, exchange, lend or make available to other organizations any personal information that you have provided to us. All personal information will remain confidential. We have safeguards in place to protect all personal information whether in print or electronic.

To view our entire privacy policy click HERE.

Have questions, concerns or need assistance?

or call 403-942-5753.