Corporate Membership Registration

Your Information

Name*

First Name

Last Name

Date of Birth*

Mobile Phone*

Email*

Address*

Address Line 1

Address Line 2

City

ZIP / Postal

Employer*

Role*

My nearest YMCA Centre*

Name*

First Name

Last Name

Mobile Number*

Do you have any reason to believe you have any kind of heart condition?*

Yes No

Have you ever experienced unexplained pains in your chest?*

Yes No

Click here to view our Terms and Conditions and Gym Rules https://www.ymcaauckland.org.nz/terms/

Acceptance*

I have read, understand and accept the gym rules and terms and conditions