Form Center

2. Membership Information

   *Online membership applications can only be accepted for pay in full memberships. If you would like to pay in 12 installments, you will have to stop by our front desk during business hours.  Thank you. 

   • You may pay in full via our online portal (non-refundable and non-transferable) 
   • You may chose to be billed in 12 installments by stopping in at the Recreation Center. 1^st payment is due when you sign up and each payment after will be charged the same day each month unless cancelled. To cancel, you must submit the online Cancellation Form 5 days prior to the next payment. Cancellations can only be done for the entire household membership. Cancellations for memberships can only be requested once in a 12 month period. 

   This is an application only.  Once submitted, a staff member will reach out to confirm your submission and review any additional information needed.  Once approved, you will have 24 hours to make payment online or in person.  A photo ID will be taken with new memberships the first time the member enters the facility and for each year after.  A key fob will be issued the first time members enter the facility for access. Online membership processing is done on weekdays only. 

4. Waiver

   Waiver and Release:   The undersigned does hereby waive, release, and hold harmless and indemnify the City of Broadview Heights and the Broadview Heights Parks and Recreation Department, their organizers, officers, employees, agents, and sponsors for any and all claims for damage of personal injury to me or loss of property that may be cause by any act or failure to act on the part of the City of Broadview Heights, the Broadview Heights Parks and Recreation Department, their organizers, officer, employees, agents and sponsors. The undersigned further assumes the risk of all dangerous conditions in and about the City of Broadview Heights, the Broadview Parks and Recreation Department property both real and personal and waive any and all specific notice of the existence of such dangerous conditions, if any. By participating in or attending any Parks and Recreation events I agree to allow publication of any photograph taken of myself/my child for advertising purposes. *By entering the building all patrons agree to adhere to the current rules and policies of the recreation center. These rules can be found online at www.bhrec.org or by request at the front desk.

6. Household Membership/Individual Membership*
   -- Select One --Household MembershipIndividual Membership

   Please indicate if this membership is a household membership for multiple people in a household, or if it is for just one person.  Please note, youth membership applications must be completed and signed by an adult. 

8. Allergies/Medical Info
10. Emergency Contact

    Please list an emergency contact phone number.  This would be preferably be someone outside the household. 

12. Name
13. Date of Birth
14. Phone Number
15. Email
17. Name
18. Date of Birth
19. Phone Number
20. Email
22. Name
23. Date of Birth
24. Phone Number
25. Email
27. Name
28. Date of Birth
29. Phone Number
30. Email
32. Name
33. Date of Birth
34. Phone Number
35. Email
37. Name
38. Date of Birth
39. Phone Number
40. Email
42. Address

    Street, City, State, Zip Code

44. Required Membership Documents

    Please attach required documents below. *Please note, information sent via this form must ONLY contain name and addresses for residency verification, and must NOT contain personal identifying information such as Drivers License numbers, ID number or anything of that nature. 

    Please Attach ID for each applying member.

    Examples - Drivers License, State ID, Military ID, Passport or Visa, Student ID

    Youth - Report Card with same address as primary member, Birth Certificate with either adult member, Drivers License with same address as primary member. 

    Proof of Residency

    If applying for a resident membership, please email proof of residency. 

    Examples (must be current within the last 90 days) - Utility Bill, Bank Statement, Credit Card Statement, Rental Agreement, Pay Stub. 

    Youth Identification can count towards youth proof of residency and does not need to be submitted twice. 

46. Required Document

    Attach required document here

47. Required Document

    Attach required document here

48. Required Document

    Attach required document here

49. Required Document

    Attach required document here

51. Required Document

    Attach required document here

52. Required Document

    Attach required document here

53. Required Document

    Attach required document here

54. Required Document

    Attach required document here

56. Required Document

    Attach required document here

57. Required Document

    Attach required document here

58. Required Document

    Attach required document here

59. Required Document

    Attach required document here

61. Signature (If under 18, parent signature required)*

    By signing this form, the above members agree to adhere to all rules and policies found at www.bhrec.org or by request at the front desk. Further, I agree that any documents I attach do not contain sensitive information and I acknowledge that anything attached is not stored on an encrypted server. 

63. Fees

    Membership Pricing	Resident Annual	Resident Annual (12 payments)	Non-Resident Annual	Non-Resident Annual (12 payments)
    Individual (18+)	$240.00	$26.00	$450.00	$49.00
    Youth (13-17), College, Senior (60+), Veteran	$120.00	$13.00	$240.00	$26.00
    Household Membership
    1st Individual (18+)	$240.00	$26.00	$450.00	$49.00
    Additional Family Member (13+)	+$65.00	+$7.00	+$85.00	+$9.00
    Additional Family Member (0-12)	+$40.00	+$5.00	+$60.00	+$7.00

Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit

* indicates a required field