Atomic Betty Membership

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* 1. Name & Mailing Address

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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* 2. Email Address

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* 3. Phone Number

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* 4. What is your age?

Under 18 (parent permission needed)

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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* 5. Would you like to listed on the Atomic Betty Club Roster?

Yes

Maybe

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* 6. Emergency Contact Information

Name

Phone Number

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* 7. The level of membership I will be purchasing is:

* Club membership benefits will not be in full effect until balance paid.
Purchase occurs on the "Membership" page in the Atomicbetty.club website

$25 - Atomic Betty Basic Level
Unique club race discount codes. Listing on USAT team roster. Support an amazing group of Atomic Betty athletes in this club.
(I agree to not share club codes to non-paying members)

$35 - Atomic Betty Bombshell Level
Unique club race discount codes, club event & merchandize discounts. Club members have the option of being featured on our website &/or social media page. Listing on USAT team roster. *Discounts on exclusive club workshops and priority workshop registration.* Support an amazing group of Atomic Betty athletes in this club.

$50 - Live Full Blast Level - Unique club race discount codes, club event discounts & provide scholarship opportunities to others. Listing on USAT team roster. *Disounts on exclusive club workshops & priority workshop registration.* Support an amazing group of Atomic Betty athletes in this club.

$100 - Atomic Betty Team Sponsor.
Unique club race discount codes, club event discounts & provide scholarship opportunities to others. Listing on USAT team roster. *Discouts on exclusive club workshops & priority workshop registrations.* Support an amazing group of Atomic Betty athletes in this club.
Partnership acknowledgement on our webpage & social media accounts, if desired.

$25 - Sponsor a Betty or Bitty Betty. Give a membership to an aspiring Atomic Betty or fund a youth (Bitty Betty) toward triathlon related endeavors.

Other (please specify)

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* 8. I agree to keep Atomic Betty Club Codes protected, as these are for paying members.

Yes

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* 9. Atomic Betty Club Waiver Agreement
I have read and agree to the terms listed in the above link.
This is also posted on the Atomicbetty.club website.

Yes

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* 10. I am a new member to Atomic Betty!

Yes

Atomic Betty Membership

Question Title

* 1. Name & Mailing Address

Question Title

* 2. Email Address

Question Title

* 3. Phone Number

Question Title

* 4. What is your age?

Question Title

* 5. Would you like to listed on the Atomic Betty Club Roster?

Question Title

* 6. Emergency Contact Information

Question Title

* 7. The level of membership I will be purchasing is:* Club membership benefits will not be in full effect until balance paid.Purchase occurs on the "Membership" page in the Atomicbetty.club website

Question Title

* 8. I agree to keep Atomic Betty Club Codes protected, as these are for paying members.

Question Title

* 9. Atomic Betty Club Waiver AgreementI have read and agree to the terms listed in the above link. This is also posted on the Atomicbetty.club website.

Question Title

* 10. I am a new member to Atomic Betty!

* 7. The level of membership I will be purchasing is:

* Club membership benefits will not be in full effect until balance paid.
Purchase occurs on the "Membership" page in the Atomicbetty.club website

* 9. Atomic Betty Club Waiver Agreement
I have read and agree to the terms listed in the above link.
This is also posted on the Atomicbetty.club website.