2023-2024 Group Membership Form

"*" indicates required fields

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

The above address is my*

Coaching Position*

School Name*

Email Address*

Cell Phone*

Are you a UIL or Private School coach?*

League*

Region*

District*

Classification*

How Many Coaches From The Same School Are You Registering?*

Number of HS/College Coaches ($30 each)*

Number of HS/College Coaches ($25 each)*

Number of JH Coaches ($10 each)*

Please add the following for each coach: First and Last Name, Email Address, Phone Number, Boys or Girls, Head Coach, Assistant or Middle School*

Do you want to pay for 2023 Clinic as well*

Do you want to pay for 2024 Clinic as well*

Please list First and Last Name and Position of each coach you are paying clinic fee for*

2023 Clinic *

Price: $75.00

2024 Clinic *

Price: $75.00

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

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