ITC Membership Registration Form

You may print this form and fax, mail or call us with class and credit card payment information.
By Fax: Indianapolis Tennis Center
317.278.0628
24 hours a day, 7 days a week
By Mail: Indianapolis Tennis Center
150 University Blvd.
Indianapolis, IN 46202
By Phone: For Visa, Mastercard, Discover and American Express users, you may call the Registration Coordinator at 317.278.2100. Please have registration information and credit card information ready. Thank You!
 
Name:
Address 1:
Address 2:
City:
State / Province:
Postal Code:
Home Phone:

Work Phone:
Emergency Contact:
Emergency Number:
Family
$350.00
IUPUI Student Semester
$35.00
Married Couple
$275.00
Junior
$100.00
Individual
$175.00
Senior
$125.00
IUPUI Faculty
$125.00
NIFS Member
$150.00
IUPUI Student Annual
$100.00
Summer
$100.00
Total Bill:
Payment Method:
Check Number:
Registrations by mail, phone or fax using Credit Cards must include the following information.
Credit Card Number:
Expiration Date:
Signature:_____________________________________