rac Membership form


your ultimate experience membership includes access during public hours to the pool, ice rink, gymnasium, fitness center, and fitness classes. It also gives you discounts on birthday parties, reservations, and more.

*Family members must be listed on the same tax return as the primary member

Primary Guardian's Name *
Primary Guardian's Name
Phone *
Address *
Date of Birth *
Date of Birth
RAC Swimmer Name *
RAC Swimmer Name
Include first and last name of your swimmer.
RAC Swimmer Birth Date *
RAC Swimmer Birth Date
Include birth date of RAC swimmer.
RAC Swimmer Name #2 (if necessary)
RAC Swimmer Name #2 (if necessary)
If you have two swimmers, this is where you can put your other child's first and last name.
RAC Swimmer Birth Date #2 (if necessary)
RAC Swimmer Birth Date #2 (if necessary)
If you have two swimmers, this is where you can put your other child's birth date.
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone Number *
Emergency Contact Phone Number
We are committed to serving families from all walks of life. You providing the information below allows grant opportunities that support our high-quality programming and your overall experience.
-I understand that members may be photographed for the possibility of being used for publicity and I give exclusive rights to these photos to the Jones Center and waive all claims for compensation for usage. -There is a non-refundable $15 yearly admin fee for all monthly and yearly memberships. -All memberships are non-refundable. -You may cancel (non-refundable) membership anytime with a written notice by the 10th of each month. -A child must be 13 or older for fitness center use and 16 or older for use without parental supervision.
I understand that the use of facilities and equipment at The Jones Center may involve risk of property damage or bodily injury including, but not limited to, broken limbs, paralysis, concussions, drowning, or even death and in consideration to my and family members use of the facility I, my heirs, representatives, executors, administrators, and assigns HEREBY DO RELEASE, INDEMNIFY, AND HOLD HARMLESS The Jones Center, its directors, employees, volunteers and participants from any course of action, claims, or demands including, but not limited to, negligence, personal injury, property damage, death, or an accident of any kind, arising out of or in any relation to the use of The Jones Center facilities. I acknowledge that my use of The Jones Center is completely voluntary, and I assuming all risk that comes with using the facility because I have read this agreement in its entirety.
If planning to pay monthly, please answer the following questions
I hereby authorize The Jones Center to initiate debit entries and to initiate, if necessary, credit entries and adjustments for any debit entries in error to my (our) account indicated below and the financial institution named below, to credit and/or debit the same to such account. Any change or cancellation to this draft must be provided by the 10th of the month in written notice by either party. Should my membership draft not be honored by my bank for any reason, I realize that I am still responsible for that payment.
Fill in the blank
Type in your 16-digit card number here. Ex. xxxx-xxxx-xxxx-xxxx
Enter the card expiration date here. Ex. "02/22".
Enter the 3-digit security code located on the back of your card here. Ex. "345".
Membership Expiration Date
Membership Expiration Date
Membership Expiration Date: If undecided, your membership will automatically renew each month until written notice before the 10th of the month. Type Membership Expiration Date that you desire.

member benefits

  • No long-term agreement

  • Free assessment with personal trainer

  • Use of locker rooms and showers

  • Free public Wi-Fi

  • Jones Center Fitness App

  • 20% off room reservations

  • 20% off birthday parties

  • 20% off activities

  • Outdoor Walking Trail

  • Tyson Food Wing

  • Community Park

Questions about our new membership pricing? See our FAQ page for more details.

Caroline Ceola
Membership Coordinator
(479) 756-8090 x 2142

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