EAAD 2025 Membership Form

Team Membership Registration Form

Please fill out the form to register for EAAD 2025 Membership
Name of Organization or Team

Team NameContact NameCoach or Officer (Add Title Please)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
Please spell it correctly for us to reach out to you
Text Number
This will only be used if we need to reach out to you immediately
Men's or Women's
Membership Dues

Returning Teams/Organization: $50.00

New Teams/Organization: $100.00

Insurance Affilation w/ EAAD: $30.00

Payment can be made via ZELLE: eaadsectreas@gmail.com OR CASH APP via $payallie and please reach out to EAAD Secertary/Treasurer Alexandria Pucciarelli Miller (eaadsectreas@gmail.com) if you have any questions.
Additional Comments
Should be Empty:

Team Membership Registration Form