Maritime Football Coaching Clinic
Registration Form

Name:       _____________________




Address:   ___________________________________________________


______________________________ ______________________________ ____________



(postal code)

Home Phone:   ________________________________________________

E-Mail Address:  ______________________________________________


Registration Fees

  Early- Before April 16 Late- After April 16
Football New Brunswick Members





Videotapes of All Clinic Sessions

Football New Brunswick Members





Note: Registration fee includes lunch

Make Cheques Payable to Football New Brunswick

Mail Payment to:
Maritime Football Coaching Clinic
c/o Dan Fougere ,38 Stanley Crescent
Moncton, N.B., E1A 4Z4

Fax Registration form or e-mail registration information to:
Dan Fougere at 506-386-3748 or
Must be faxed or e-mailed by April 19 to get early rate.
Payment can then be made at clinic registration desk.