This is our 25th Clinic !!

PRE-REGISTRATION DEADLINE: Thursday, DECEMBER 31, 2016.
PAYMENT MUST ACCOMPANY REGISTRATION FORM. NO P.O.s ACCEPTED.

TYPE the data in the boxes - PRINT the form - WRITE the dollar amounts - SUBMIT Form and Check.

Full Name: Cell Ph:
St Address: Home City:
Home State: Home Zip:
Home Email:    


District Affiliation...                

 


$115.00 - Pre-Registration

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$20.00 - "RAWLINGS" Hall of Fame Luncheon (Pre-registration required)

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$20.00 - Sports Med. Certification (Pre-registration required)

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TOTAL ENCLOSED

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Make Checks Payable to OHSFSCA (non-refundable). No P.O.s Accepted.
Send Check and Registration to: OHSFSCA, PO Box 5453, Poland, OH 44514