Nike Coach of the Year Football Clinic Registration

 ( This application is for mail in only. Please print and mail to the address below.)

Registration fee for the full clinic:  $80.00, $70.00 for OACA members, additional $5 discount per coach for four or more coaches from the same school. 

After February 28, 2008, $90 per person

Name: ____________________________________________________

Address: __________________________________________________

City/State/Zip: ______________________________________________

School/Organization: _________________________________________

Email:_____________________________________________________

List all coaches included in the enclosed payment:

1. ________________________________________________________

2. ________________________________________________________

3 .________________________________________________________

4. ________________________________________________________   

5. ________________________________________________________

Registration enclosed for          coaches at $80 each = $                          

    $10 each less discount for being an OACA member                           

     $5 each less discount for 4 or more coaches                                        

Total Payment Enclosed                                                     $                          

(Please add any additional coaches on back of registration form)

Mail form and check to: OACA 3295 Triangle Dr., Suite 100, Salem, OR 97302

Credit cards can also be used as payment. (If using a personal credit card include home address and zip.)

Credit Card #: _____________________________ Exp date: ________

Credit card name if different:____________________________________________

Total Amount Charged __________