February 20th, 2010
Blacksburg Middle School
Ages 6-12 8:00am-12:00pm
Ages 13-18 1:00pm-5:00pm
Name _______________ School/Team______________________________
Address_______________________________________________________
Phone______________ Age _____
e-mail ____________________________________________
__Morning Session ___ Afternoon Session (please check one)
T-shirt Size (adult) S M
L XL
XXL
Please make checks out to Travis Bishop.
Please mail registration to:
Hands-On Goalkeeping School
c/o Travis Bishop
1895 Canter Drive
Riner, VA
24149
Your registration is NON-REFUNDABLE!!