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Contact Us

5429 32nd NW
Seattle, WA 98107
Phone: (206) 297-0403
Fax: (206) 297-0558

Hours

Monday 8:30 AM - 4:30 PM
Tuesday 8:30 AM - 4:30 PM
Wednesday 8:30 AM - 9:30 PM
Thursday 8:30 AM - 4:30PM
Friday 8:30 AM - 4:30 PM

Quarterly Tidings

February 2012 Highlights

February Highlights

You are here > Support Us > Become a Member

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Membership

Center membership is not required to participate in our activities but there are benefits to being a member. Dues are $30.00 per year. You may use the online form OR download an application.

Membership means:

Lower fees for classes, trips, foot care and other items.
Invitations to Members Only Events.
Free birthday lunch.
Acknowledgement of your support for the center.

Please complete and mail your Membership Form to:

The Ballard NW Senior Center
5429 32nd Ave. NW
Seattle WA 98107

Please make checks out to the Ballard NW Senior Center.

If you prefer, you can download, print and complete a membership application by first clicking this link for the PDF Membership Application.

Thank you for your participation!

Dynamic Forms

Full Name:

Street:

City:

State:

ZIP:

Telephone:

Work phone:

Email Address:

Best Time to Contact You:

Membership Type:
New
Renewal

Gender:
Male
Female

Age:
Under 50
Over 50

Date of Birth (MM/DD/YYYY):

How Did You Hear About Ballard NW Senior Center?:

What Are Your Current Interests or Hobbies? :

Are You Looking to Volunteer at the Center? If So, Where?:

Emergency Contact Information

Full Name:

Emergency Contact Relationship:

Phone:

Doctor's Name:

Doctor's Phone:

What medical, medication or health concerns should we know about?:

Release
In consideration for being permitted to attend, observe, participate and engage in the activities and functions sponsored or co-sponsored by the Ballard NW Senior Activity Center and/or Senior Services of Seattle King County, I release, relinquish and waive any and all claims, demands, causes of action, liabilities and obligations, of any nature or kind, for personal injury, death or property damage which I may now or in the future have against the Ballard NW Senior Activity Center and/or Senior Services of Seattle King County, and their respective directors, officers, employees, agents, independent contractors and representatives, which arise out of or are related or incident to my attendance, observation, participation or engagement at any activities or functions sponsored or co-sponsored by the Ballard NW Senior Activity Center and/or Senior Services of Seattle King County.

Signature: (Note: typing in your name as you sign it constitutes your signature.):

Date: