US Squash/MSSRA

Membership Form

 

Please click here for Membership or fill out this form and return

 

Each individual must fill out a separate form.

 

Name:___________________________________________________________

Phone:     H_______________________________________________________

                                  W_______________________________________________________

 

        Email:_____________________________________________________________

 

        Address:___________________________________________________________

_________________________________________________________________

          ________________________________________________ Zip______________

 

Date of Birth: __________/__________/__________

 

 

ADULT MEMBERSHIP

20 years + older:  $95 annually

 

JUNIOR MEMBERSHIP

Under 20 years:  $65 annually

 

Enclosed:_____________________________________________________

 

_____additional tax deductible contribution

 

Please make checks payable to

MSSRA

C/O Andrew Cordova

1 East Eager Street

Baltimore, MD   21202

 

Visit us on the Web at

www.mssra.org

 

  

 

  

The United States Squash Racquets Association

And the Regional Chapter

Maryland State Squash Racquets Association

Sponsor the Following Activities: