Lifetime Membership Fees

Think about a lifetime Membership

Under 24 - $1219.00
Age:25-29 $1160.00
Age:30-34 $1095.00
Age:35-39 $1024.00
Age:40-44 $ 946.00
Age:45-49 $ 862.00
Age:50-54 $ 772.00
Age:55-59 $ 679.00
Age:60-64 $ 585.00
Age:65-69 $ 493.00
Age:70-74 $ 406.00
Age:75-79 $ 325.00
Age:80-84 $ 233.00
Age:85-Over $ 206.00

NEW MEMBERSHIP FORM

Download Form

New Membership Form
Wenatchee Valley Senior Activity Center

Annual Membership is $35.00 for individuals or $55.00 per couple. Lifetime memberships are also available.

Date _______/_________/_______ (Today’s date must be filled in)

If you are already a member, use this form ONLY to correct or update records.

Name: ______________________________________________BD______ -______-______

Spouse Name: _______________________________________ BD_______-______-______

Address____________________________________City_________________________Zip___________

Home Phone (___)_____________ Cell Phone (___)____________

Email Address:______________________________________________

 

In Case of Emergency notify:

Contact Name __________________________________________    Phone ___________________

Relationship ___________________________

Physician name ___________________________________   Phone ___________________

I am being treated for:
__________________,__________________,_______________,_____________________

Medications: _____________,_____________,_______________,_________________,_______________

I have the Following allergies:___________,_______________,______________,_______________

Release of Liability:
By participating in Wenatchee Valley Senior Activity Center activities and or programs, I agree that the Senior Activity Center, it’s Officers, directors, agents and employees are not responsible or liable for any injury, loss, illness, litigation, or damage arising from such activities or programs.

Signature ____________________________________     Date ____________________