JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Polar Bear Club Shirt Pre-Order
By completing this form you are expressing your interest in joining the Polar Bear Club and agree to pay $10.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First and Last Name:
Your answer
YMCA Member Number (located on your card):
Your answer
Phone Number:
Your answer
Email Address:
Your answer
Shirt Size:
S
M
L
XL
XXL
XXXL
XXXXL
Clear selection
Preferred Location for Pick Up:
Lighthouse
Lohse
Northwest
Ott
Clear selection
I understand that by placing this pre-order, I agree to pay $10 to join the Polar Bear Club and shirt.
Yes I agree to charge my account $10
No.
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of YMCA of Southern Arizona.
Report Abuse
Forms
