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USIndoor Corporate Membership Application

Complete the form below or use a printable form to complete by hand.

CONFIDENTIAL

Company Name:

State/Province of Legal Organization:

Business Type:

If Other:

Address:

City:

State:

Zip:

Telephone:

Fax:

Website:

Primary Contacts

Name (Contact 1):

Title:

Telephone:

Fax:

Email:

Name (Contact 2):

Title:

Telephone:

Fax:

Email:

Years in Business:

Years in Product/Service Lines:

Total Number of Customers:

Bond Rating (if any):

Please describe the product/service lines, intended to be promoted through a relationship with USINDOOR.

Product	Description	*Standard Price	USIndoor Price (if different)

Please list any attachments, including brochures and other pre-printed materials, as needed to provide information and to summarize any results of testing or analyses for quality standards or comparisons:

Principals (Names):

OR Publicly Traded On (Please list exchange):

Other entities in related business lines with which principal(s) has/have been affiliated and holds or held an ownership interest. Please identify company name, place of organization, and all fictitious names:

Has a principal ever been convicted of a felony or crime involving theft, fraud, extortion, bribery or perjury, or an attempt to do so, or been involved in bankruptcy (referred to below as "a Proceeding")?

Is a principal currently involved in a Proceeding, as defined directly above?

Have you or a principal ever applied and been denied membership in, or been expelled from, a trade association?

REQUIRED FOR USINDOOR'S REFERRAL PROGRAM

Confidentiality Policy

Certain agreements with USINDOOR contemplate the delivery of confidential information, pertaining to personal, sales, contact and other market data, to a select group of corporate members, whether by email, other written correspondence, or word of mouth. Because any unauthorized disclosure of this information could dilute the value of such agreements, such members must agree to be responsible for the information's security.

If COMPANY desires to receive such information, please indicate here and outline the measures that COMPANY will take to protect USIndoor's confidential information from being disclosed or becoming available to any unauthorized personnel or third party (e.g., employee, agent, independent contractor or other third party.) Response required if opting into Referral Program

Please describe how COMPANY will communicate and enforce USINDOOR's confidentiality requirements respecting personnel with authorized access to USINDOOR's confidential information, and attach your required confidentiality agreement, if any. (USINDOOR's form of confidentiality agreement is available upon request.)

Response required if opting into Referral Program

Please identify all formal and informal relationships of COMPANY (including of its employees and agents), which do or could involve the sharing of trade information relating to the indoor sports industry, including whether COMPANY can and would strive to control the dissemination of confidential information any such relation received from USIndoor:

Relationship	Description/Product(s)	Controllable?

In addressing concerns with the foregoing relationships, any information that you could provide to assist USINDOOR in involving other companies in the membership program would be appreciated (attach pages as necessary):

Final Comments:

COMPANY acknowledges that the accurate completion of this document is a condition of becoming a member of USINDOOR and the basis for the parties' subsequent membership agreement, and warrants that the individual whose name is below is duly authorized to submit this form, as is. If this form is submitted electronically, such individual further verifies and warrants that his or her typed name shall constitute a legal signature for the purposes expressed herein, as of the date entered.

Submitted by (company name):

Signature:

Print Name:

Title:

Date:

United States Indoor Sports Association
1340 N. Great Neck Rd., #1272-142
Virginia Beach, Virginia 23454
E-Mail: info@usindoor.com
Fax: 509-357-7096

Features

United States Indoor Sports Association,
1340 N. Great Neck Road, Suite 1272-142 | Virginia Beach, VA 23454-2268
Fax: (509) 357-7096 | Email: pr@usindoor.com
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