2014 ESSC Registration Form

Hotel and clinic registration deadlines
have been extended to October 10th

MAIL TODAY with your pre-registration fee(s) made payable to: Eastern States Swim Clinic c/o Sue Davis, 341 Springhouse Lane, West Chester, PA 19380. POSTMARKED BY October 6, 2014. Only ONE NAME per registration form - Please print legibly. Mail this form with payment or register online. No purchase orders accepted.

Name:_____________________________________________________________________________

Home Address:_____________________________________________________________________

City:_______________________   State:__________   Zip:__________

Phone (     ) _______________   E-mail Address:______________________

Club/School Affiliation: ___________________________________________

Type of Program:_College    _H.S.    _Age Group    Length of Season:______________________

Optional courses:

  Coach $180: ______ 

  Swimmer (8 yrs & up) $170: ______     
  Age: ______

MAIL YOUR REGISTRATION FORM TODAY!! DON’T MISS THIS CLINIC!!

Don’t forget your hotel reservation for special clinic rates.

Certified Stroke Technician (Th) $50.00 ____
Working Successfully with Swimming Parents (Th) $50.00 ____
The Physiology School (Fri) $60.00 ____
Creating Leadership -The Process (Fri) $50.00 ____
USA Club Leadership/Business Mgt. (Th/Fri) $20.00 ____