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Region/Division Membership Change Request
Please use this form to request a region or division membership change for the following USA Climbing Series: Youth, Elite, Collegiate, Paraclimbing and Recreational.
Membership Policy
: Familiarize yourself with our current membership policy before submitting this request.
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* Indicates required question
Email
*
Your email
MEMBER INFORMATION
Please submit one form per request.
Name
*
As listed on their USA Climbing member profile
Your answer
USA Climbing Member Number
*
Your answer
USA Climbing Series
*
Youth
Collegiate
Elite
Paraclimbing
Recreational
Previous
Region/Division
*
Currently listed in their member profile
Choose
Region 11
Region 12
Region 21
Region 22
Region 31
Region 32
Region 41
Region 42
Region 51
Region 52
Region 61
Region 62
Region 71
Region 72
Region 81
Region 82
Region 91
Region 92
Heartland
Mid-Atlantic
Northeast
Rocky Mountain
South Central
Southeast
West Coast
New
Region/Division
*
Choose
Region 11
Region 12
Region 21
Region 22
Region 31
Region 32
Region 41
Region 42
Region 51
Region 52
Region 61
Region 62
Region 71
Region 72
Region 81
Region 82
Region 91
Region 92
Heartland
Mid-Atlantic
Northeast
Rocky Mountain
South Central
Southeast
West Coast
Reason for Change
*
Change of primary residence (new address below)
Change of team affiliation/gym
Moving to/from college
Selected by mistake
Other:
New Primary Address
if applicable, enter new primary address (
street, city, state and zip
) here
Your answer
Requester's
Name
*
Your answer
Send me a copy of my responses.
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