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Get USHPA Membership Application/Renewal Form 2011-2024

Y USHPA. Current members may renew 90 days prior to expiration. I HAVE READ, UNDERSTAND AND AGREE TO THE OFFICIAL USHPA RELEASE, WAIVER AND ASSUMPTION OF RISK AGREEMENT AND HAVE SIGNED IT AND PROVIDED IT TO USHPA. Name Gender ( M / F ) USHPA# Address Address Country City State/Province Phone Birthdate M / D / Y Zip/Mailcode Email MEMBERSHIP CLASSES - Choose Division & Membership Type Please check one: HG PG Both Please fill out this form. SIGN AND DATE THE WAIVER. CC p.

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