RTA Registration Form

MEMBERSHIP ENROLLMENT FORM
Print, fill out & mail it to Richmond Tennis Association
P.O. Box 17612, Richmond, VA 23226

Name:

______________________________

TYPE OF MEMBERSHIP

Birth Date:

________/_________/_______

Junior Individual ($15 per year)

______

Association, Club or School:

______________________________

Adult Individual ($25 per year)

______

Address:

______________________________

Family ($35 per year)

______

City:

______________________________

Life Family ($250)

______

Zip:

______________________________

Corporate/Business Sponsor ($1,000 per year):

______

Email Address:

______________________________

Charitable Donation ($________)

______

Home phone:

______________________________

Parent Name (if Junior):

______________________________

RICHMOND TENNIS ASSOCIATION
P.O. Box 17612
Richmond, VA 23226
Phone: 754-4315
Fax: 754-4316

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