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Flag Summer Clinic Sign-up Form
Contact Name
*
First
Last
Contact Cell
*
Genders
*
Boys
Girls
Contact Email
*
Grade Sept 2017
*
Grade 9/10
Grade 7/8th
Grade 5/6th
Grade 3/4th
Grade 1/2nd
Choose One
*
I’m mailing full payment of $80 (Early Bird discount) if postmarked before Wednesday June 21st
I'm mailing full payment of $95
Make Checks Payable to: NEB
Mail Checks to: NEB, PO Box 1336, Plaistow, NH 03865
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