Local Sports Club Membership Information
Ball State University Local Sports Club Membership Information Athletics Compliance Office
Name:
Age:
Address of Legal Residence:
Distance from Club (miles):
Dues Paid:
Please utilize an additional form if required. Signature of Coach: Signature of Owner/Operator of Club: Signature of Athletics Compliance Office:
Date:
Date:
Date:
Ball State Athletics Compliance 6.10.2015 MCC
Name:
Age:
Address of Legal Residence:
Distance from Club (miles):
Dues Paid:
Please utilize an additional form if required. Signature of Coach: Signature of Owner/Operator of Club: Signature of Athletics Compliance Office:
Date:
Date:
Date:
Ball State Athletics Compliance 6.10.2015 MCC
