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Riverside Park Conservancy

119 Tennis Assoc. Membership & Activity Form

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

(All fields are required unless marked otherwise.)

There is an error with the following required field(s):

    Player Information
    Electronic Ladder
    Tournament Participation

    Please select the tournament(s) you would like to play in. ($30.00/singles, $50.00/doubles or $25.00 per person*)

    *Both doubles partners are required to be 119TA Members

    For specific tournament dates and up to the minute information, go to: http://www.119ta.net/tournaments.

    Total Membership & Tournament Fees

    Member Dues for 2018: $50.00

    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 the Conservancy and the 119TA membership family and we will not sell, lend or exchange your name.

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

    Credit Card Processing
    On Visa, Discover and MasterCard, this is the 3-digit number printed on the back signature panel or to its right. American Express cards have a 4-digit code printed on the front. None of them is embossed.
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