Wisconsin Basketball Coaches Association

Membership Registration - Package

$200 - Membership Package

Please fill out the following.
Minimum 10 Coaches. Maximum 20 Coaches.

Organization Info:

School / Organization

Address

City

State

Zip

Athletic Director (required)

If the Athletic Director is also a Coach, please select "Team Gender" and "Team Level", otherwise leave blank.
*Required Fields. No Duplicate Emails Allowed.

*Name

Gender

Level

*Address

*City

*State

*Zip

*Email

Fall Clinic?

Coaches

*Required Fields. No Duplicate Emails Allowed.

*Name

*Gender

*Level

*Address

*City

*State

*Zip

*Email

Fall Clinic?

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20

Package Total:

$
200

Clinic Total:

$
0

Total Order:

$
200