Bermuda Athletic Association Membership - Renewal | BermudaTix part of the Incentis family

Please choose your membership level: *

Senior Citizen - Over 65 (BAA) - $ 125.00

Junior - under 18 (BAA) - $ 50.00

Senior - 18 to 65 (BAA) - $ 250.00

Couple (BAA) - $ 375.00

BermudaTix fee *

BermudaTix fee - $ 2.00

Optional donation

Total Amount

Name and Address (BAAS):

Applicant First Name *

Applicant Last Name *

Occupation

Birth Date, if under 18 (MM/DD/YYYY)

Gender *

Mailing Address *

Postal Code

Country *

Parish *

Home telephone:

Mobile phone:

Work phone:

Email *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City (do not use in Bermuda)

Country *

Parish/State/Province *

Postal Code *

Add'l info (BAAS)

If registering as a Couple, please type the name, email and contact telephone for your spouse/partner.

Spouse/Partner information

Sport:

Team:

Role (How you can assist the club):

I have read and agree to the terms and conditions of the Personal Liability Release Agreement *

Yes

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