Booking Form

Available

Booked

Time Slots*

First Name*

Last Name*

Adult Date of Birth*

Email*

Address (Street, City, State, Zip Code)*

Phone*

Childs Name*

Age*

Date of Birth*

Gender*

Expected # of Guests*

Package Selection*

Add - Ons

Additional Swimmers (Pool Parties include 15 swimmers)*

How many additional swimmers?*

Groups must provide adult supervision (1 adult per 10 children).

The YMCA is an alcohol, drug and smoke free facility. None of the aforementioned items are allowed on YMCA property.

No children are allowed in the men’s or women’s locker room – please use boy’s and girl’s locker rooms for changing. Those 18+ years old are allowed only in the men’s or women’s locker room. A family changing corridor is available for families/individuals.

Parties are not confirmed until availability is confirmed by YMCA staff and event is payment is made in full. Reservations are held for 3 business days.

Mason City Family YMCA reserves the right to cancel any or all future reservations by any guests acting or deemed inappropriate.

Please Initial. I hereby acknowledge that I will abide by the rules and regulations of the YMCA and accept full responsibility for the conduct, supervision, and safety of our group using the facilities and agree to reimburse the YMCA for any damages that should occur from the group’s usage. I leave any pricing for the damages at the discretion of the YMCA if this should occur and will reimburse the YMCA. I and all parties attending the event do not hold the YMCA accountable for any property damages or bodily injury arising out of the scheduled activity while coming to, being on, or departing from the YMCA premises. The YMCA reserves the right to make changes to the facilities allocated and will notify the applicant accordingly. In the event that the YMCA shall be obligated, hindered, or prevented from providing the use of the facilities for any reason, the YMCA shall be excused from delivery of the facilities as otherwise herein provided without further liability. The applicant acknowledges the YMCA is under no obligation to provide services or facilities not previously requested.*

Signature - typing your name below acts as a signature*