USCF Membership Form

Membership Type (Circle)

Scholastic age 12 and under

$17

Youth ages 13 - 15

$19

Young Adult ages 16 - 25

$25

JTP Grades K-3 or K-12 for club only

$0

New Membership

Renew Membership

ID#

First and Middle Name

Last Name

Suffix

Examples (Jr.  III)

Sex (circle)

Male

Female

Birthdate

MM/DD/YY

Address Line 1

Apt#

Address Line 2

Street address

City

State/Zip

Email ID