USHPA Waiver Form

USHPA Waiver Form

Please fill out the USHPA form below.

    * Required fields

    Participant's Name *

    Email *

    Your USHPA # *



    Please Sign Below *



    did you pay your membership fee?

    After completing your paperwork you must pay your membership fee via cash (to CBSS Club Officer) or Venmo to @Ben-Eaton-22 (CBSS Treasurer). Current membership dues – $120 annual or $60 monthly.

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