UpTurn Intake Form 2024

Please complete the Intake Form below to begin your membership process through the UpTurn Program at YMCA Northumberland, sponsored by the Ryan Huffman Foundation.

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PERSONAL INFORMATION

Full Name*
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Address

SUPPORTING INFORMATION

Please select all that apply:
Are you willing to attend a monthly meeting for all UpTurn Program Members?*

LEGAL DOCUMENTATION


We acknowledge the important step you have taken in registering for the UpTurn Program. As a final step to complete the registration process, please review the UpTurn Program Membership Contract document below regarding the terms and conditions and other important policies in effect as a member of YMCA Northumberland through the UpTurn program. Simply click on the document to open and review the PDF document. You can also print it off. Once you have reviewed the document, please provide your consent by selecting “I agree” and inserting your name below. Thank you!

UpTurn Program Membership Contract
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