PRINTABLE REGISTRATION FORM
Please print and fill out.
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Yes, please register me for the Toliver Basketball Officiating School. My $285.00 deposit is included. Balance is due by May 15, 2002 (deposit is non-refundable after May 1, 2002). I am applying for the following tuition option: (check one of the following)

_____Option I (with meals) $420 includes insurance, meals, lodging, T-shirt, and photo.

_____Option II (without meals) $380 includes insurance, lodging, T-shirt, and photo.

_____Option III (day camper only, no lodging) $325 includes insurance, meals, T-shirt, and photo.

_____Option IV (day camper only, no lodging, no meals) $285 includes insurance, T-shirt, and photo.
 
 Name  ______________________
Address  ______________________
City  ______________________
State  ______________________
 Zip Code  ______________________
Home
Phone
 ______________________
Business
Phone
 ______________________
Fax  ______________________
Email  ______________________
T-Shirt
Size
L-XL-XXL
 ______________________
Roomate
Preference
 ______________________
Current
Level
Officiating
 ______________________

__________________________ 
Signature

_____________
Date

Please mail completed form and
deposit (check or money order) to:

George Toliver Officiating School
P.O. Box 283
Harrisonburg, Virginia 22803

To Receive a Copy of the Registration Form in the Mail, Send a Stamp Addressed Envelope to the Above Address
 

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