Gym Membership Application

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First Name

Last Name

Phone

Street Address

Mailing Address/PO Box

Are you reqesting a reduced membership rate? You may be required to provide eligibility documentation.

Senior Citizen (65+)

Emergency Services (Fire, EMS, Sheriff, SAR)

Student (Recent Silverton Graduate)

I understand and agree to the following:

I am a San Juan County resident and meet the membership criteria.

I understand that I will be required to sign and abide by a Gym Use Agreement.

I understand that I will be required to sign a Gym Liability Waiver.

I understand that I will be required to abide by current public health protocols.

I understand that if I share my key card or provide gym access for unauthorized individuals, my membership will be immediately revoked with no refund.

RETURNING MEMBERS: I understand that I must return my old key card and receive a new one.

I understand that my application for membership is subject to review, and membership is not guaranteed. Current membership levels, gym utilization, and public health concerns are reviewed by the Superintendent and School Board when determining acceptence of new members. Silverton School does not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status.

Thanks for your application. We will reach out to you as soon as possible. We aim to process new membership requests within two weeks of submission. If your application is approved, you will be asked to come in to the school office to sign your paperwork and make payment.

Silverton School

Silverton, Colorado

1160 Snowden Street

PO Box 128

Silverton, CO 81433

business@silvertonschool.org

(970) 387-5543

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