Maritime Football Coaching Clinic
Registration Form

Name:       _____________________

 ______________________________

(first)

 (last)

Address:   ___________________________________________________

(street)
______________________________ ______________________________ ____________

(city/town)

(province)

(postal code)

Home Phone:   ________________________________________________

E-Mail Address:  ______________________________________________

 

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

$30

 $40
Non-Members

$35

 $45

Videotapes of All Clinic Sessions
Football New Brunswick Members

$10

  
Non-Members

$15

  

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 tlglass@nbnet.nb.ca
Must be faxed or e-mailed by April 19 to get early rate.
Payment can then be made at clinic registration desk.