REGISTRATION FORM

DICK KERIN/SWOFCA FOOTBALL CLINIC AT THE UNIVERSITY OF CINCINNATIRegistration can be made by Cash, Check, Money Order or Venmo. Pre-Registration / Registration is $15 per Coach, or a school can opt for the staff fee of $100, which covers up to 10 coaches. Staffs wishing to cover their entire program including junior high, junior varsity, and the varsity coaches can pay a program fee of $175.00

List of Coaches Attending:

1. _______________________________________________________

2. _______________________________________________________

3. _______________________________________________________

4. _______________________________________________________

5. _______________________________________________________

6. _______________________________________________________

7. _______________________________________________________

8. _______________________________________________________

9. _______________________________________________________

10. _______________________________________________________

Amount Enclosed: ______________________________________________________

School Name: __________________________________________________________________

Address:______________________________________________________________________

_______________________________________________________________________

City: _________________________________________ ST: __________ Zip: ______________

Mail Completed Registration Form and Payment to:

SWOFCA / Jon Sheehan3654 Matson Ave

Cincinnati, OH 45236Make Checks Payable to SWOFCA

For More Information Call: 513-482-1414 or 513-226-4343