Registration & guardian

Chicago, IL — MEMBERSHIP. Enter participant details, then continue.

1 Registration

Silver - Annual Membership

$150.00

Gold - Annual Membership

$250.00

Platinum - Lifetime Membership (1 Time Payment)

$3500.00

DONATION

$1000.00

2 Player Information

Membership dues level pricing reflects a 10% discount available for new members and memberships renewed by August 1, 2013.

First name:

Last name:

Email:

Username ( lowercase letters and/or numbers ):

Password ( type this twice please ):

Verify Password ( type this twice please ):

Additional Info

Address:

Address2:

City:

Province / State:

Postal / Zip Code:

Home Phone:

Office Phone:

Mobile Phone:

Fax:

Secret Question:

Secret Answer:

Online Contact Info

Facebook URL (example: http://www.facebook.com/username):

Twitter URL (example: https://twitter.com/#!/username):

LinkedIn (example: http://www.linkedin.com/in/username):

Stats

Position:

Height:

Date of Birth:

e.g. mm/dd/yyyy

Weight:

High School:

College:

Draft:

NBA Debut:

Jersey Number:

Business Info

Occupation:

Company:

Website (example: http://www.urladdress.com):

Personal Appearance Fee:

Charity Info

Charity Name:

Charity Appearance Fee:

Personal Appearance Contact:

TERMS & CONDITIONS

The NBRPA will automatically renew your Annual Membership dues each year, using the credit card infromation you provide. If you do not want your membership to be automatically renewed, you must notify the NBRPA on or before October 1st of each year via email at memberalert@legendsofbasketball.com or via fax at 312.913.9401.

I HAVE REVIEWED AND AGREE WITH THE TERMS & CONDITIONS LISTED ABOVE FOR THE 2014 MEMBERSHIP DUES:

YES