_____Option I $425 includes insurance, meals, lodging, T-shirt, and photo.
_____Option II $350 (no lodging) includes insurance, meals, T-shirt, and photo.
_____Option III $300.00 (no lodging, no meals) includes insurance, T-shirt, and photo.
Name
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Address
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City
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State
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Zip Code
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Home Phone
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Business Phone
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Fax
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Email
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T-Shirt Size L-XL-XXL
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Roomate Preference
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Current Level Officiating
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Signature
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Date
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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.