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): ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________   ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 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