MASTERS OF DEFENSE CLINIC

REGISTRATION AND PAYMENT

$199
Please fill out form and click on the submit button when finished.

Also, print a copy of this page and submit with your payment.
Name:
Address:
City and Zip:
Cell Phone:
Email:
DOB:
Team:
Position
Program
Choice
 

Send check (payable to SportSciTek) and completed form to:

Bruce Turpin
9010 Bennett Avenue
Evanston, IL 60203

OR