WMOA Football Clinic Registration
Name

First
Last
Crew Chief

First
Last
MHSAA # *
Affiliation/Association
Email
Phone Number

###		-
###		-
####

Do you desire to work a scrimmage? *
 yes 
 no 
preferred day:
 Thursday 
 Friday 
 no preference 
preferred time:
 3:00pm 
 6:00pm 
 no preference 
Primary position
 R 
 U 
 HL 
 LJ 
 BJ 
Secondary position
 R 
 U 
 HL 
 LJ 
 BJ 
Desired position for scrimmage
 R 
 U 
 HL 
 LJ 
 BJ 

Submit registration form and make payment using PayPal or send check to:

Curt Johnson
855 Pheasant Ridge
Hastings, MI 49058
Image Verification
captcha
Please enter the text from the image:
[Refresh Image] [What's This?]

Powered byEMF HTML Form Builder
Report Abuse