Name:
Email Address:
Phone Number:
Over 18?
Years Experience
Clinic Dates:(if you are signing up for more then one clinic you must fill this form out for each clinic: Safe Haven, Jerry Whitehead Elementary School Wednesday June 4th, 2008, 6 – 9 pm
Safe Haven, Jerry Whitehead Elementary School Thursday June 5th, 2008, 6 – 9 pm
Safe Haven, Bud Beasley Elementary School Tuesday July 8th, 2008, 6 – 9 pm
Safe Haven, Bud Beasley Elementary School Friday July 18th, 2008, 6 – 9 pm
U10/U12 coaching clinic, Shadow Mountain Sports complex Saturday July 12th, 2008, 8am to 4 pm U10 finishes at 1 pm after lunch. Lunch provided by Region 166
U6 Roster night/coaching clinic, Bud Beasley Elementary School Monday July 14th, 2008, 6 – 8:30 pm
U8 Roster night/coaching clinic, Bud Beasley Elementary School Tuesday July 15th, 2008, 6 – 8:30 pm
U15 Intermediate coaching clinic, Shadow Mountain Sports Complex Saturday July 19th, 2008, 8 am to 4 pm, and Sunday July 20th 9 am to 1 pm Lunch provided by Region 166 on Saturday only.
U10 Keeper clinic, Shadow Mountain Sports Complex July 28, 29, 30, 6:00 – 8:30 pm Bring keeper gloves and a ball. You must attend three nights.

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