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SSV PICKLEBALL CLUB MEMBERSHIP FORM

MAKE CHECK PAYABLE TO: SSV PICKLEBALL CLUB

Name

(Last, First)

Name on

Name Tag

Email Address:

Primary

Phone #:

Emergency Contact:

Emergency

Phone #:

Give this form and payment to a Membership Committee member or

drop at the SSV HOA office drop box.

Cheri Laney (602-430-6730) and Glenda Wilson

(319-269-9082) Check #:__________

Annual Membership ($30): Returning ______ New ______

Lifetime Membership: Returning ______

Membership Committee Use Only

Membership Committee: Amount Date Initials

Badge Punched

DB Updated: