Application For The Rebounders
Questions marked by * are required.
1. Name: *
2. Address:
3. City:
4. State:
5. Zip:
6. Business:
7. Email: *
8. Phone:
9. Status:
  • New Membership
  • Renewal
10. Choose A Plan Below
  • Regular $100
  • Student $50
  • Couple $150
  • Student Couple $75
  • Family Plan $175
  • Student Family Plan $87.50
11. For Family or Couple's Plan - Spouse Name
12. Children's Name (Under 18 Only)
13. Method Of Payment: *
  • Check
  • Credit Card
14. Make Checks payable to: U of M Rebounders MAIL TO: REBOUNDERS * PO BOX 172054 * MEMPHIS, TN 38187-2054
15. Card Type
  • Visa
  • Mastercard
  • Discover
  • American Express
16. Name On Credit Card:
17. Card #
18. 3 Digit Security Code
19. Expiration Date
20. Comments:
21. How Did You Hear About Us?