2010 PNBA MEMBERSHIP
FORM
MEMBERSHIP FOR PROFESSIONAL ATHLETES
BE PART OF
THE WORLD WIDE LEADERS IN NATURAL BODYBUILDING AND FITNESS
And
support drug-free sports
USE IT FOR $10 OFF YOUR REGISTRATION, IF YOU ORDER $100 IN
XTREME NATURAL SUPPLEMENT PRODUCTS!
**COMPLETE ENTIRE FORM*PLEASE PRINT NEATLY**
** SEND MEMBERSHIP FORM IN NOW**
First Name__________________________________________Last Name______________________________________
Address____________________________________________________City_____________________________________
State________________Zip/Postal Code_________________________Country_________________________________
E-mail_________________________Home Phone_______________________Work Phone_______________________
Birthday_________/_________/_________Age________________ Height________________Sex_________________
Occupation______________________________________________ Date of Application________/________/_________
GYM INFO.
Name_______________________________________________________
Address_____________________________________________________
City___________________________State_________________________
Zip/Postal Code__________________Country______________________
Interested in: Bodybuilding____Fitness_____Figure_____Model
Search_____
Bikini Divas_____ Kids and Teens Fitness_____
Applicants Signature__________________________________________________
If Under 18 Parent's Signature__________________________________________
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Please Send My: 2010 PNBA
Membership* $125.00, after January 31, 2010 $150 (NO REFUNDS!) Be sure to pick the contests you are going to compete in by April 1, 2010! Please Choose: Visa______ Mastercard_____
Check_____ Money Order_____ Card #:_________________________________________ Exp. Date____________ 3digit code_____ Signature____________________________________________________________ Please Make Checks & Money
Orders Payable To: "Mt. Olympus Inc."
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