Registration Back to Main Clinic Page

Make Checks payable to:                                           Return to:
Bureau County Track                             Bureau Valley High School
Clinic Cost:  $60 per coach if  MAILED by Jan.24th     9154 2125 N. Ave.
                    $85 after Jan. 24th or at the Door                Box 329
                                                                                     Attn.: Dale Donner
                                                                                     Manlius IL  61338

School Name____________________                         Coaches:

School Address__________________                         _____________________________

_______________________________                     _____________________________

City ___________________________                      _____________________________

Zip ____________________   

Amount Paid  ___________                                       _____________________________

Email address (if any) _____________                       _____________________________

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