HSPN Member Registration Form
*Name and Address:

*E-mail address #1 : 					  E-mail address #2 :

*Phone Number :

* = Required

Charter Member              Team Member                    Organization Member
==============              ============                   =================== 
                                                           Team Names: (up to 4)                   
                             Team Name:

                             Sport:                       
 
                             Age Division:                  Sport(s):



                                                            Age Division(s):


Preferred                  Preferred                        Preferred 
User Name:                 User Name:                       User Name:
Password:                  Password:                        Password:



(  ) $ 20.00               (  )    $ 50.00                  (  )    $ 100.00



===============================================================================
My signature below signifies an agreement with HSPN (Homeschool Sports Network) to become a HSPN member on an annual basis.  My membership fee dictates the level of my membership.

 
  Signed  on  the  _____  day of ______________ ,  2003        


_________________________________________
                 	                                    					   your signature


Return to:  HSPN, PO Box 69, Linden, VA   22642        540.636.3713
================================================================================