Skip to main content
User account menu
Log in
Select Language
Main navigation (mobile)
Membership
Join
Manage Membership
Membership Benefits
Try the Y
Programs
Child Care & Camp
Community Impact
Health & Fitness
Sports & Activities
Swimming
Classes & Schedules
All Schedules
Walnut Creek Family YMCA
Waukee Family YMCA
Wellmark YMCA
Locations
Walnut Creek Family YMCA
Waukee Family YMCA
Wellmark YMCA
Y Camp
YMCA Supportive Housing Campus
About
Events
Leadership
Mobile App
News
Child Abuse Prevention
A Leading Nonprofit Organization
User account menu
Log in
Select Language
Main navigation
Membership
Join
Manage Membership
Membership Benefits
Try the Y
Programs
Child Care & Camp
Des Moines Y Camp
Infant through Preschool
Kids Zone
School Age
Summer Day Camp
Community Impact
Access for All
Drowning Prevention
Summer Learning Loss Prevention
Volunteerism & Giving
Health & Fitness
Active Older Adults
EGYM
Fitness Classes
Medical Programming
Personal Training
Small Group Training
Sports & Activities
Adult Sports
Basketball
Football
Girls on the Run
Other Sports
STEAM Youth Enrichment Classes
Soccer
Y Achievers
Swimming
Competitive Swim
Lifeguard & Safety Training
Swim Lessons
Water Exercise
Water Safety
Classes & Schedules
All Schedules
Walnut Creek Family YMCA
Waukee Family YMCA
Wellmark YMCA
Locations
Walnut Creek Family YMCA
Waukee Family YMCA
Wellmark YMCA
Y Camp
YMCA Supportive Housing Campus
About
Events
Leadership
Mobile App
News
Child Abuse Prevention
Current
General Information
Interest and Experience
Availability
References
Certification
Complete
Name
First
Last
Email Address
Current Address
Address
Address 2
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
ZIP/Postal Code
Date of Birth
Phone Number
Have you ever been convicted of a criminal offense? If yes, please explain.