2010 WBCA Clinic Membership Form
To receive full WBCA membership benefits, you must join by May 1st, 2010.
COMPLETE ALL BLANKS AND PRINT OUT!

Your name:
School or organization:
Home Mailing Address:
City, State, Zip
Home or Cell Phone
Baseball Title (Head, Asst...)
Email Address
Spring/Summer/Other Spring Coach Summer Coach Other
Check One: Membership and Clinic ($80) Clinic Only ($55) Membership Only ($40)... PAY AT THE DOOR IS $90

*Pay by Check (made out to the WBCA) or Credit Card (Visa or Mastercard only)
No purchase orders will be accepted. No preregistration or refunds after February 1st, 2010.
$80 includes All Speakers, Lunch, Yearbook, Social, and Membership. Membership also includes Brewer Tickets: Tickets are buy one ticket at regular price, get the 2nd ticket for free, up to four, excluding Premium Games. The offer is for the day of game only. Use gates 7-12. You need to have your WBCA Membership Card with a laminated picture of yourself on the card to qualify for this offer.
You need to get your own hotel room! Call the Madison Mariott West at Toll-free: 1-888-745-2032.
Please be clear and accurate with your personal information so we can contact you if necessary. This information is kept private!

FILL IN ALL BLANKS, PRINT OUT AND MAIL THIS FORM AND A CHECK (MADE TO WBCA) or submit Credit Card Information:
Mail to: Tom Wilson, 437 Pleasant Way, Seymour, WI 54165

Credit Card Authorization: Visa MasterCard .......... Account #: Expiration Date:

Signature: ___________________________________________________