SU Chat Chill (Senior Meet & Greet) 1/28/26

Summit AREA YMCA Chat & Chill (Senior Meet & Greet)

A welcoming space for seniors to connect, share stories, and build friendships.

Summit YMCA
67 Maple Street, Summit NJ

Wednesday January 30th
12:30 PM – 1:30 PM

Please complete one registration form per guest.
GUEST INFORMATION
Guest Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Email*
example@example.com
Member Status*

Berkeley Heights YMCASummit YMCAThe Learning Circle YMCANot a memberOther
Ethnic Origin*

WhiteBlack/African AmericanNative Hawaiian/Pacific IslanderAsianAmerican Indian/Alaska NativeTwo or More RacesPrefer not to sayOther
Please note: Y-USA requests the above information from YMCA participants throughout the nation for program funding and demographic purposes.