Membership Form
Full Name _________________________________
Address _______________________________________________________________________
Birth Date ______________________________ Email __________________________________
Home Phone_____________________________Cell Phone_____________________________________
USAB Member No._________________________________Exp. Date_____________________________
Other Family Members:
Full Name______________________________________ DOB_______ Email:_______________________
USAB Member No._____________________________Exp. Date___________________________
Full Name______________________________________ DOB_______ Email:_______________________
Full Name______________________________________ DOB_______ Email:_______________________
| Membership Type (check one): | ||
| _____New Premier Member | ______Returning Premier Member | |
| _____New Family Premier Member | ______Returning Family Premier | |
| _____New Day Member | ______Returning Day Member | |
| Payment information | Amount Due | Form of Payment |
| _____Annual | ______Cash | |
| _____Semi-annual | ______Check | |
| _____Monthly | ______Credit Card |
Play Level:
OA OA- OB+ OB OC+ OC OBeginner
What else are you looking for:
O Coaching
O Fun Leagues
O Regional tournaments
O Active involvement in junior development
O Active involvement in Club competition and other activities
O Active involvement in tournaments
O Club tournaments and ladders
O Local tournaments
O Would you like to volunteer in club's events and activities?
