Club Membership Registration Form

Pirate Pride Booster Club Membership Registration

Complete the form below to electronically register and pay dues for your Annual Membership.

Select Here to Confirm*

2015 Annual Membership Dues$25.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

E-mail*
Phone Number:

Area CodePhone Number
Membership Sports Shirt Gender:*
Membership Shirt Size:*
Notice #1: Submission of your email address will be kept confidential by the Pirate Pride Booster Club, while also added to the organization eNotification List.

Notice #2: The donation fee of $25.00 shall be considered membership dues and will include membership ID card, and a membership male or female collared sports shirt.
Once you submit your application, we will contact you shortly to complete your membership process.

Thank you!
Should be Empty:

Pirate Pride Booster Club Membership Registration