Use this printable registration form to register for:

Fisher's 2009 Wisconsin Diving Camp

Name______________________________________________________________________
Address_____________________________________________________________________
City_________________________________State__________Zip Code__________________
Home Phone (       ) ___________ Parent's Work Phone  (      )_______________
Age______________  Graduation Year_______________________________
School_________________________Coach's Name______________________
T-Shirt Size (adult) S_____ M_____ L_____ XL_____
Roommate preference______________________________________________
Insurance Co. Name (accident) _______________________________________
Policy Number ___________________________________________________

Divers Email Address:  __________________________________________________

 

July 19-24,  2009:   Held at U.W. Osh Kosh    

          _____Commuter ($330)       ______Resident ($445)

Please check one of the following: (if you are registering after May 30, full payment must be enclosed)

                 Full payment enclosed _____
                 Deposit of $100_____ (needed to hold spot, not refundable for any reasons)

                                           Mail this registration to:    Fisher's Diving Camps
                                                                                  S. 480 Oregano Road
                                                                                  Ontario, WI   54651

  For more information call: Coach Joe (608) 337-4528