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Main navigation
Home
Virtual YMCA
Programs
Health & Fitness
Find a Program
Active Older Adults
Coaching Connection
Community Health
Group Exercise Classes
Group Training
Health Coaching
LIVESTRONG at the YMCA
Parkinson's Support
Personal Training
Schedules
Sports
Westridge CrossFit
Children & Teens
Afterschool
Center Childcare
Middle School Programs
Sports
Time Out for Parents
Sign Up
The Y Teen Career Club
Swimming
BCS Aquatics Center
Lifeguard Certification
Patton Pool
Piranhas Swim Team
Safety Around Water
Specialty Training
Swim Lessons
Find a Class
Camps
Half-Day Camps
Overnight Camp
School's Out Camps
Summer Day Camps
Find a Day Camp
Community
Diabetes Programs
Diversity and Inclusion
Falls Prevention
Financial Assistance
Food Programs
Volunteer
Schedules
Locations
About
About the Y
Contact
GIVE
Impact
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Events
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Community Health Interest Form
This form does not register you for any Y program. You will be contacted by a member of the Community Health team (by phone, then email) after you complete this form. Thank you!
First Name
Middle Name
Last Name
Date of Birth
You can maually enter your DOB or use the calendar icon.
Phone
Email
Primary Language (How can we better serve you?)
Primary Language (How can we better serve you?)
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English
Spanish
Other…
Enter other…
Are you a Y member?
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Yes
No
What program are you interested in?
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Taking Control of Type 2
Diabetes Prevention Program at the Y
LiveSTRONG at the Y
EnhanceFitness
Moving for Better Balance
Health Coaching at the Y
Parkinson's Programs
How did you hear about our programs?
How did you hear about our programs?
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Doctor
Employer
YMCA Website
YMCA Social Media
YMCA Staff Member
Other…
Enter other…
What time do you need class?
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Morning
Afternoon
No Preference
At which YMCA location would you be interested in attending class? (Check all that apply)
Asheville YMCA
Black Mountain YMCA
Corpening Memorial YMCA
Ferguson Family YMCA
Hendersonville Family YMCA/Kellogg Center
Reuter Family YMCA
Woodfin YMCA
Other…
Enter other…
Would you prefer if the class was virtual?
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Yes
No
Additional Comments