The Fastbreak Club: The official booster club of Lady Dog basketball

Fastbreak Club Online Membership Application


Need more information or want to mail in your membership form? View our current membership brochure here.

IMPORTANT: Completing this form requires payment by credit card or PayPal. If you prefer to pay with a check, please complete the paper membership form and send it in with your check.

   

Names

Your first name:
Your last name:
Total in household (including you):
Are you a season ticket holder: Yes No

Contact Information

Address:
City:
State:
ZIP:
Primary contact phone:
Secondary phone:
Email address:

Membership

Please refer to the chart to the right for membership levels. The minimum donations are $40 for individuals and $60 for households.

Membership amount:

Membership Levels

  • Individual: $40+
  • Lay-up: $60-$99
  • Assist: $100-$199
  • Rebound: $200-499
  • 2-point: $500-999
  • 3-point: $1,000-$2,499
  • Double-Double: $2,500 or more
$.00

Once you submit this form, please click the PayPal button to complete this application using a credit card or your PayPal account. This application will not be considered complete without a corresponding payment.