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Coaches Enrichment Retreat
July 10-12, 2009

Coaches Retreat Registration

Name*
Spouse
School Name*
Position*
Address*
Address 2
City*
State*
Zip Code*
Phone Number*
Email Address*
Security Image*
	What is a security image?

Payment Information
Price per person: $299
Card Type*	Visa MasterCard Discover
Name of Cardholder*
Credit Card Number*
Card Expiration Date (MMYY)*
Security Code (3-4 number code on reverse of card)*
Amount*

All packages include two (2) nights accomodations at the Westin Stonebriar Resort, four (4) meals, all sessions and breakouts and special gift. (Saturday lunch is on your own. All other meals are included)

Billing Address*
Billing Address 2
City*
State*
Zip Code*

All rates are based on double occupancy, if you are a single coach and desire to come and share a room with another coach, please include their name and school below. We will confirm your regsitration once both are received. If you would prefer a single room, please note that in the Roomate line by listing it as NONE.

Roomate Name
Roomate School
Additional Notes

* indicates a required field

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