MUNCIE SPORTSPLEX MVP MEMBERSHIP REGISTRATION

Name

Address

City State Zip

Home Phone Work Phone

Email Address * mandatory

Membership Level : Bronze ($10) Silver ($25) Gold ($50) Platinum ($100)

Payment Method: Cash Check Credit Card (Visa or Mastercard)

If paying cash or check, mail or drop off your payment to: 425 N High St., Muncie, IN 47305

If paying by credit card, call 765-284-2700.

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