Coaches vs. Cancer Information

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Coaches v Cancer Basketball Coaches Clinic – September 14, 2008

Registration Form

Name _____________________________________________

Address ___________________________________________

             ____________________________________________

School or Program that you Coach ____________________________

Phone __________________________________

Email Address ___________________________

*** If this registration form is for several individuals, please list their names in the space provided:

1.) ____________________   2.)_______________________

3.)_____________________  4.)_______________________

5.)_____________________  6.)_______________________

FEES :          $40.00 per person --- if received prior to September 1, 2008

          $50.00 per person --- if registering after September 1 OR at Door  

** Checks made payable to: Germantown Academy Basketball

Please send this form to :          Jim Fenerty

                                                c/o Germantown Academy

                                                P.O. Box 287

                                                Fort Washington, PA 19034

For Directions to Germantown Academy --- Go to www.germantownacademy.org