tryptich
2011
COACH WYATT CLINICS
PRE-REGISTRATION FORM
MAIL WITH CHECK or MONEY ORDER or SCHOOL P.O. to...
COACH HUGH WYATT - 1503 NE 6TH AVENUE - CAMAS, WA 98607
$125 AT THE DOOR - $100 PRE-REGISTRATION
PURCHASE ORDERS MAY BE E-MAILED TO coachwyatt@aol.com (OR FAXED TO 360-834-0718)

PLEASE READ CAREFULLY - the pre-registration discount is offered in order to assist us with our planning - therefore, no refunds of pre-registration fees will be made for cancellations within 10 days of the clinic date

CLINIC SITE:_________________________________________________

NAME ____________________________________________________________________________

ADDRESS _________________________________________________________________________

CITY/STATE/ZIP ___________________________________________________________________

PHONE ___________________________________________________________________________

E-MAIL ADDRESS _________________________________________________________________

SCHOOL/ORGANIZATION __________________________________________________________

NO. OF COACHES ___________ TOTAL AMOUNT (@ $100) ________________

(MAKE P.O., CHECK OR MONEY ORDER PAYABLE TO "COACH HUGH WYATT")

COACH(ES) WHO WILL BE ATTENDING (PLEASE PRINT - WE WILL USE THIS TO MAKE NAME BADGES):

___________________________________________

___________________________________________

___________________________________________

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PLEASE READ CAREFULLY - the pre-registration discount is offered in order to assist us with our planning - therefore, no refunds of pre-registration fees will be made for cancellations within 10 days of the clinic date