Join the YMCA of Rapid City

 
Please contact the YMCA at 605-718-9622 or email the YMCA of Rapid City here for membership options such as scholarships and corporate partnerships.
At present, online applications are only available for the YMCA of Rapid City.
To join the YMCA of Custer, please call 605-673-5134 or email the YMCA of Custer here.
To join the YMCA of Edgemont, please call 605-622-7999 or email the YMCA of Edgemont here
First Name
Middle Initial
Last Name
Date of Birth
Gender
 Male
 Female
Address
City
State
Zip
Home Phone
Cell Phone
Email (Age 18+)
Do You Have Health Concerns
 Yes
 No
If Yes, please list:

Household Information

First Name, Middle Initial, (Last, if different)
Gender
 Male
 Female
Date of Birth
Relationship
Cell Phone
Do You Have Health Concerns
 Yes
 No
If Yes, please list:
First Name, Middle Initial, (Last, if different)
Gender
 Male
 Female
Date of Birth
Relationship
Cell Phone
Do You Have Health Concerns
 Yes
 No
If Yes, please list:
First Name, Middle Initial, (Last, if different)
Gender
 Male
 Female
Date of Birth
Relationship
Cell Phone
Do You Have Health Concerns
 Yes
 No
If Yes, please list:
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone Number
Your Employer (to determine corporate rate eligibility)
Spouse Employer (to determine corporate rate eligibility)

Income & Ethnicity

The YMCA is committed to serving people regardless of their inability to pay. We need to know whether we are reaching all income levels. The information will be strictly confidential and will help us to better serve the community.

Annual Household Income
 Under $20k
 $20k - $30k
 $30k - $40k
 $40k - $60k
 $60k - $90k
 Over $90k
Ethnicity
 Asian American
 African American
 Hispanic
 Native American
 Caucasion
 Other

Buck-A-Month Club

 Yes
 No

By checking "Yes," I agree to join the Buck-A-Month, whereby an additional amount per month will be added to my membership fees in support of the YMCA building fund. By checking "No," I do not wish to join the Buck-A-Month Club.

 $1.00 per month
 $5.00 per month
 $10.00 per month
 $25.00 per month

Terms & Conditions

PLEASE AGREE TO THE TERMS & CONDITIONS IN ORDER TO JOIN ONLINE.

TERMS AND CONDITIONS PHOTO/VIDEO RELEASE AUTOMATIC PAYMENT AUTHORIZATION

 

I Agree to the Terms & Conditions
I am over 18 years of age
I Agree to the Photo and Audio/Video Recording Release
 
Agree to the Automatic Payment Authorization