Complete this form to get your 1-day YMCA pass.

This day pass is valid for all 18 Metro Atlanta YMCA locations. Photo ID required to redeem this day pass. Please note, day passes do not include access to outdoor pools at any YMCA.

Guest Pass Form


MEMBER ASSUMPTION OF RISK/RELEASE OF LIABILITY
AND AGREEMENT TO YMCA POLICIES

OUR PROMISE TO YOU

The YMCA of Metro Atlanta endeavors to provide a safe environment and programs for you, your family
and guests. The YMCA provides exciting, life-enhancing programs that involve exercise, travel, learning,
and sports. These programs, however, necessarily have a certain amount of risk associated with them. The
purpose of this Agreement is to secure your agreement to assume these risks, on behalf of yourself and
any children or other minors for which you are legally responsible, and to ensure you are aware of and
adhere to certain YMCA safety and other policies.

ASSUMPTION OF RISK AND RELEASE OF LIABILITY
I acknowledge and agree that use of any of the YMCA of Metro Atlanta facilities, services, equipment or
premises (the “Facilities”) necessarily involves risks of injury to my person and property, and to the
person or property of any child or legal ward of mine (hereinafter “dependents”) that I have requested or
allowed entry to or use of the Facilities. By engaging in such use, or permitting use by a dependent, I
voluntarily accept and assume full responsibility for these risks.
In consideration of the use of the Facilities, I agree that the Metro Atlanta YMCA and its directors,
officers, members, employees, volunteers, and agents (collectively, the “YMCA”) will not be liable for
any injury to my person or property or to the person or property of any dependent of mine.
Further, on behalf of myself and my legal successors, I do hereby release, discharge and hold harmless the
YMCA from any and all liability and claims arising from my use, or use of a dependent of mine, of the
Facilities. I further covenant not to sue the YMCA with respect to, and I waive any and all claims that I
may have now or in the future against, the YMCA for any liability arising from the use of the Facilities.
This waiver includes, but is not limited to, all liability and claims arising from personal injury (including
death), accidents or illness and damage to, loss of, or theft of property. I understand that, notwithstanding
the foregoing, should I sue or file any claim against the YMCA, or threaten to sue or file any such claim,
the YMCA may terminate my membership privileges and my involvement in any program or activity of
the YMCA.

BY SIGNING AT THE BOTTOM OF THIS AGREEMENT, I UNDERSTAND I AM RELEASING
THE YMCA FROM ALL LIABILITY TO ME, AND MY DEPENDENTS, FOR ANY AND ALL
LOSSES AND DAMAGE TO ME OR SUCH DEPENDENT, AND I FOREVER GIVE UP ANY
CLAIMS THEREFOR ON ACCOUNT OF INJURY TO PERSON OR PROPERTY, WHETHER
CAUSED BY THE NEGLIGENCE OF THE YMCA OR OTHERWISE.

FOR YOUR HEALTH
It is my responsibility, prior to engaging or permitting any of my dependents to engage in any YMCA
exercise program or other activity involving physical activity, to consult with my physician to determine
whether I and my dependents are medically able to engage in the program or activity. It is my
responsibility to monitor my own condition and those of any dependents throughout any activity and,
should any unusual symptoms occur, to cease participation and inform the YMCA staff of the symptoms.
I give permission to any YMCA staff person to administer first aid in the event of an emergency and to
summon 911 response units for any medical treatment needed for me and my dependents. I understand
that the staff will try to phone the emergency contacts in my YMCA household record, but is not required
to do so before action is taken. I agree that any medical expenses incurred by me or my dependents will
be my responsibility.

FOR YOUR SECURITY
I understand the YMCA premises, parking lots and locker rooms are provided for members’ and guests’
convenience while participating in YMCA programs. The YMCA is not responsible for vandalism, breakins or thefts of personal property. I understand the YMCA recommends that valuables should not be
brought to program activities or onto any premises. I agree to report any suspicious activity immediately
to the staff. I understand that it is my responsibility to request, read, and after enrollment abide by the
refund, cancellation and fee payment policies connected to specific membership and program
involvement.

YOUR CONDUCT
I and my dependents will not bring weapons, controlled substances or alcohol on YMCA premises. I
understand that any form of solicitation is prohibited, and the use of violence, noise, force, coercion,
sexual misconduct, threats, intimidation, unsafe conduct regarding children, fear, resistance, insults, or
other conduct, intentionally or unintentionally causing disruption or preventing YMCA members’ ability
to enjoy their program activities, membership or YMCA staff’s and/or volunteer’s ability to conduct class
or their job duties, is not acceptable behavior, is in conflict with YMCA values, and may result in my or
my dependent’s program withdrawal or termination. I am aware that the YMCA reserves the right, within
its sole discretion, to withdraw program involvement and membership privileges to anyone for any reason
that the YMCA, in its sole discretion, considers appropriate or in the interests of the YMCA and/or its
patrons.

SEX OFFENDER POLICY
The YMCA conducts regular sex offender screenings on all members, participants, and guests. If a sex
offender match occurs, the YMCA reserves the right to cancel membership of any member, end program
participation, and remove visitation access.

POLICY ON PHOTOGRAPHY
I authorize the use and reproduction of any and all photographs or video footage of myself or my
dependents for YMCA promotional purposes without compensation, and I understand that it is the
personal responsibility of members and their guest(s) to avoid being photographed if they so desire.

By signing at the bottom of this Agreement or electronically accepting this Agreement, I agree that I have
read this entire Agreement and understand my responsibilities, and those of my dependents, for
participation and conduct in YMCA programs and activities.

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