Registration Form (highlight page and print it)

Name _____________________________________________________Age______

Address___________________________________________________

            ___________________________________________________

Telephone # _______________________________________________

Telephone # (cell) ___________________________________________

Email: _____________________________________________________

Playing Level _______________________________________________
               
                    _______________________________________________

Amount Enclosed _______________   $140 per 5 weeks of play
                                                                                                             

                                                NO REFUNDS 

Please mail completed registration form to:

George Haley
5 Elizabeth Ann Dr.
Johnston, RI 02919

For further information call George @ 401.487.2627 or Email him @ coachhaley@cox.net.