Injury Free Coalition for Kids
Membership Registration

Use this form to register for membership.
Remember to mail your applicable dues payment to the address below.

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Membership Level

Organization Membership ($2500)

Individual Platinum Membership ($500)

Individual Gold Membership ($100)

Trainee (dues waived)

Verification

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Membership dues payment: Please make your check payable to the Trustees of Columbia University in the City of New York, and send by mail to:

Injury Free Coalition for Kids
Attn: Barbara Barlow, MD
PO Box 580
Tenafly, NJ 07670