AAU Membership

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E-mail Address:		(E-mail)
First Name:
Middle Name:
Last Name:
Address:
City:
State:			Zip Code:	(US ZIP Code (5 digits))

Home Phone:		(Example 111-222-3333)
Work Phone:		(Example 111-222-3333)
Birth Date:		(Example mm/dd/yyyy)

Gender:		- Male - Female
Youth Program consists of athletic participation for ages as defined by AAU Youth sport rules. Basic Youth ages are 1 to 20. Youth Membership allows participation/coverage in any and all youth sports. Adult Program consists of athletic participation for ages as defined by AAU Adult sports rules. Basic Adult ages are 21 and over. Adult membership is sport specific and allows participation/coverage for one sport only.
Step 1	Program:
Step 2	Membership Term/Category:
Step 3	Sport:
Club Name:
Club Code:
Do you have Health and Accident Insurance:		- Yes - No
Auto Renewal:		May we conveniently renew your membership when it expires using your information provided?		- Yes - No