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College Clinic Registration Form

MHSFCA
College Registration Form


 

First Name Last Name
Coach 2:
Coach 3:
Coach 4:
Coach 5:
Coach 6:
Coach 7:
Coach 8:
Coach 9:
Coach 10:
Coach 11:
Coach 12:
Coach 13:
Coach 14:
Coach 15:
Coach 16:
Coach 17:
Coach 18:
Coach 19:
Coach 20:

Payment Amount

Enter "1" under Number for College Table.
Items
Item Number Cost Total
College Table at Clinic and College Seminars
College Seminar (1, 2, or 3 events)
College Seminar (4 or more)
Total Payment:

Credit Card Payment

Your credit card will be charged the amount listed under Total Payment.  Enter all informaton below and click Submit.  

Visa Mastercard/Eurocard American Express Discover Network

 

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