JAMES MICHAEL CURLEY COMMUNITY CENTER
1663 COLUMBIA ROAD
SOUTH BOSTON, MA 02127

FOR FACILITY USE ONLY
Member #:________________
LC#:_____________________
Check#:__________________

STOP Do not complete this Application if you already have a memership card. Please bring your card in for renewal.
Please PRINT CLEARLY or your application may not be processed. CHECK or MONEY ORDER only.

Name:____________________________________________________ Date:________________________________

Street Address:_______________________________________________________________________________________

City/State/Zip Code:___________________________________________________________________________________

Phone:
_________________________________ Male______ Female______ Date of Birth:____________________
Have you ever been a Member? (check one) Yes (card was lost______ No______

Annual Membership
Please Check Your Selection


Membership Types:


Membership Fees:

Aerobic Membership
General Membership
Senior Aerobic Membership (65 years of age and older)
Senior General Membership (65 years of age and older)
Lost Card Replacement
$90.00 / includes classes
$70.00
$25.00 / includes classes
$10.00
$10.00

The above-information is factual and complete to the best of my knowledge.

I, ____________________________________________, hereby waive and release any and all rights, causes of action, and claims for damages I may have against the City of Boston, Boston Centers for Youth & Families, and any and all other associated individuals or organizations, for any and all personal injuries or property damage resulting from my participation in Boston Centers for Youth and Families Programs.

MEMBERSHIP OFFICE located at K Street entrance / HOURS: Monday-Friday 9:00 AM - 2:00 PM / 3:00 - 8:00 PM

   
No refunds after five (5) days from date of purchase.
Memberships are non-transferable.
No one under the age of 16 is allowed in weight, sauna, and steam rooms.
No bags, coats or boots are allowed in weight or class studios.
Lockers are available. Bring a lock. No articles are to be left overnight.
The facility is not responsible for lost or stolen items.
Work out at your own risk.
Please respect staff and other members at all times. Harrassment
and/or inappropriate behavior will not be tolerated and may result in
termination of membership. Address your concerns with a staff member or supervisor.

Member's Receipt

 

Name:___________________

Amount Paid:_____________

Date/Staff:_______________

 


print this page