Beckerman Recreation Center Alumni Membership Application

Application for University of New Haven Alumni to purchase a membership to the University of New Haven's Beckerman Recreation Center.

We currently offer monthly repetitive memberships to alumni for $25 per month. In order to be eligible to purchase the Alumni membership, you must provide proof of graduation. Our Membership Team will create your membership profile and email you when you may come to complete your payment and sign your agreement at the Beckerman Recreation Center Welcome Desk.
This process can take 10-14 business days.

Please visit http://www.newhaven.edu/student-life/health-wellness/chargerrec/membership.php for more membership information.

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Are you a former TeamREC employee?

Are you a former TeamREC employee? Yes No
Applicant Name on ID Applicant Name on ID First Last
Applicant Preferred Name Applicant Preferred Name First Last
Date of Birth Date of Birth / MM / DD YYYY
Gender Identity
Applicant Address Applicant Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Applicant Phone Number Applicant Phone Number - ### - ### ####
Would you like to opt in for SMS messages from ChargerREC through the RecAuto system?

Would you like to opt in for SMS messages from ChargerREC through the RecAuto system? Yes No I'm not sure
Applicant Email
Emergency Contact Emergency Contact First Last
Emergency Contact Phone Number Emergency Contact Phone Number - ### - ### ####
Authorization:
I understand the following:

I understand the following: Prices may be different than posted above I will review membership policies and procedures upon signing membership agreement Payments must be made in the form of credit card or debit card (American Express is not accepted) I acknowledge that, at their discretion, the University of New Haven may choose to deny my membership application to the Beckerman Recreation Center or revoke my membership at any time as they deem necessary.
Name Name First Last
Date Date / MM / DD YYYY
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Beckerman Recreation Center Alumni Membership Application

Beckerman Recreation Center Alumni Membership Application

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