119 Tennis Assoc. Membership & Activity Form

To become a member, please fill in the information requested below.

(All fields are required unless marked otherwise.)

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    Player Information
    119TA Membership

    Total amount to be charged to your credit card: $50.00

    If you prefer to pay by check, print this form after filling out the above portion. Checks should be made payable to RPC/119TA and mailed to:
    119th Street Tennis Association
    c/o Riverside Park Conservancy
    475 Riverside Drive
    Suite 455
    New York, NY 10115

    Billing Information

    We value your privacy and we will not sell, lend or exchange your name.

    Card Expiration Date

    If your company has a matching gift program, please don't forget to send us the form.