World Wakeboard Association
2006 Membership Form
5205 S. Orange Ave Suite 205, Orlando, FL 32809

Membership Type: (PLEASE CIRCLE ONE)

$50.00             WWA T-shirt, copy of the 2006 WWA Boat Evaluation Handbook, Up to $25,000 Annual Accidental Medical Insurance, E-mail broadcastings on events in your area, Newsletters (sent via email), and Cool Industry Stuff.
                        MUST ADD $15 SHIPPING AND HANDLING FOR ALL ADDRESSES OUTSIDE OF THE UNITED STATES OR PACKET WILL NOT BE SENT.
                                *One per household.

$35.00             Will receive an official WWA membership card valid for one year, up to $25,000 Annual Accidental Medical Insurance, E-mail broadcastings and newsletters

Date: _________________ T-shirt Size (sm, med, large, x-large) _________________
Name: _________________________________________________________________
Address: _______________________________________________________________
City:  ________________________________ State:  __________ Zip: _____________
Phone: _______________________________ Email: ___________________________
Date of Birth: __________ Division: ____________ Contest: ____________________
Payment (circle one):            Visa                 Mastercard                Check
Credit Card #: ___________________________________________ Exp: __________
Check #: ________________                                Amount Paid: ___________________
Name on Card (please print):_______________________________________________
Cardholder Signature:____________________________________________________
Note: Any information received and is not legible will be disregarded without refund.
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RECEIPT
NOTE: It is the responsibility of the rider to receive and maintain this portion for future references or disputes on membership.  If any questions please contact the WWA office at 407-362-7841 or via email at membership@thewwa.com.

Date: ___/___/_____ Event Name/ Club Name ________________________________________________
Rider Name: ____________________________________________________________________________
Issued by (Please print):  __________________________________________________________________
Form of Payment (VISA, Master Card, Cash, and Check): _______________ Amount: _______________
Check Number if Applicable: ___________________