O-LINE CLINIC CAMP Online Registration Form:Please be sure to fill out this form as completely
as possible to ensure proper registration. |
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| (*) Fields are required for successful form submission. After you have filled in all the required information, checked the camp/s you want to attend, PLEASE read the entire bottom of this page CAREFULLY before clicking the 'submit' button. THANK YOU! | |
(Payments only by Credit Card and PayPal.)| Name: | * |
| Address: | * |
| City: | * |
| State: | * |
| Zip: | * |
| Phone: | * |
| Parents' Names: | |
| Email Address: | * |
| Year in School (Fall of 2008): | |
| Birthdate: | |
| Height: | |
| Weight: | |
| High School Name: | |
| Address: | |
| City: | |
| State: | |
| Zip: | |
| Coach's Name: | |
| Coach's Phone: |
1. O-LINE CLINIC CAMP - Phoenix - March 29-30, 2008 Exact Site TBA | |
2. O-LINE CLINIC CAMP - Los Angeles - April 12-13, 2008 JSerra HS, 26351 Junipero Serra Road, San Juan Capistrano, CA | |
3. O-LINE CLINIC CAMP - Las Vegas - April 19-20, 2008 Exact Site TBA | |
5. O-LINE CLINIC CAMP - Chicago - May 3-4, 2008 St. Xavier University, Chicago, IL | |
6. O-LINE CLINIC CAMP - Dallas - May 17-18, 2008 North Texas University, Denton, TX | |
6. O-LINE CLINIC CAMP - Minneapolis-St.Paul - May 31-June 1, 2008 Minnetonka HS, Minnetonka, MN | |
7. O-LINE CLINIC CAMP - Milwaukee - June 7-8, 2008 Carroll College, Waukesha, WI | |
8. O-LINE CLINIC CAMP - Seattle - July 11-12, 2008 Bothell HS, Bothell, WA -Closed for 2008 |
| Hold Harmless / Notice of Insurance (click here to read) | |
| Insured by : | |
| Policy Number : | |
| Payment Method : Credit Card / PayPal / Personal Check * This field must be filled. | |
| Refund Policy (click here to read) | |
| Comments: Use this space for submitting any pertinent information that you feel we need to be aware of regarding attendance at our O-LINE Clinic Camps. Thank you! |
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| PLEASE REVIEW THE ABOVE INFORMATION before submitting this form.
If you have any questions, feel free to call us today at (262) 549-9010. We look forward to you joining us at one of our clinic camps! PRINT THIS PAGE for your records before clicking on the "Submit Form" button. AFTER you click on the Submit Form button you will automatically be taken to a page where you will be able to pay for your o-line clinic camp with credit card or Paypal or make a deposit. A full payment or $150 deposit is REQUIRED to secure your clinic space. |
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