Sign Up | Childcare for ECPI Students & Employees

Our team will review your information and add the discount to your YMCA account, which will automatically apply in your shopping cart for one year.
To renew your discount, you can fill out this form again or stop in at your local YMCA to show proof of employment or student status.
You only need to fill out the form for one child. Your discount will apply to all children on your account.

Child's Name

Child's Date of Birth

Parent's Name

Parent's Email

Parent's Phone

Do you already have a YMCA account?

Address

City

State

ZIP Code

Parent's Date of Birth

We use this information to set up your YMCA account.

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