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Coaching Workshop Early Registration Form Please check ( ) the Workshop you plan to attend:

o July 10-12, Edina, MN

0 August 28-30, Camp Greenkill, Huguenot, NY

Participant Information: Club Name: _ _ _ _ _ _ _ _ _ _ _ __ Address _ _ _ _ _ _ _ _ _ _ _ _ __

Contact Person: _ _ _ _ _ _ _ _ _ _ __ City_ _ _ _ _ _ _ _ _ State _ _Zip _ __

Phone, day (_ _ )_ _ _ _ _ _ _ __

Phone, night (_ _ _ _ _ _ _ _ _ _ __

Social Security Number

Participant names:

USGF Pro-number

Coaching Safety PDP WorkshopCertification Levell

1. ______________________ _ _ _ _ $95

2. ______________________ _ _ _ _ 3. ______________________ _ _ _ _ 4. ______________________ _ _ _ _ 5. _____________________ ____

$95 $95 $95 $95

0$75 0$75 0$75 0$75 0 $75

0$35$ _ __ 0 $35$_ __ 0 $35$_ __ 0 $50$_ __

o $3::5 -== $ =====----.

1$--

Sub-total for fees:

Discounts: • Early Registration Discount* • USGF Professional Member Discounts: Number of coaches attending the Coaches Workshop Number of coaches taking the Safety course/exam Number of coaches participating in PDP Level I course

=

$_---

= = 5=

$_--$_-$

_ _ (no.) x $ 5 _ _ (no.) x $20 _ _ (no.) x $ 5 _ _ (no.) x $

Individual Totals

SUb-total for discounts:

1- $

I$

Fee enclosed:

*IN ORDER TO RECEIVE THE ABOVE DISCOUNT, REGISTRATION MUST BE POSTMARKED BY:

June 15th for the Edina, MN workshop August 1st for the Huguenot, NY workshop CHECKS SHOULD BE MADE PAYABLE TO: United States Gymnastics Federation If paying by credit card:

Card:

0 VISA

0 MasterCard

Card # _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date_ _ _ _ __ Card holder name: _ _ _ _ _ _ _ _ _ _ _ _ Signature _ _ _ _ _ _ _ _ _ _ __

<$> ~ )

LEJ -

J.>J~~

USGF COACHES ED UC ATION

TECHNIQUE May 1992

Please return this registration form to: USGF EDUCATIONAL SERVICES Pan American Plaza, Suite 300 201 S. Capitol Avenue Indianapolis, IN 46225 (T592)

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Technique Magazine - May 1992  
Technique Magazine - May 1992