PSOA – Wendelstedst 2021 Clinic Flyer

2021 PSOA Wendelstedt Clinic Registration Form

Full Name* (required)

Address* (required)

City* (required)

State (required)

ZIP* (required)

Primary Phone* (required)

Your Email (required)

***Please indicate if you would like a room only for you or a shared room with another. Rates: $120 single occupancy, $60 double occupancy. ***

Hotel Options (optional)

PREMIER SPORTS OFFICIALS ASSN
Sean Johnston, Founder
7001 N 153rd St. Bennington NE 68007
402-319-8413
st_rita1920@yahoo.com