Name ______________________________________                            Click here for PDF version

Street ______________________________________    

City _______________________________________

State _________________  Zip _________________

Home Telephone _____________________________

Email Address ________________________________________

Promotional Code (if applicable): _______

How did you hear about the Navy Performance Enhancement Clinics?
 Internet         Chesapeake Family Magazine   navysports.com
 What's Up?   Friend    Other _______________________________

Clinic: September 28, 2008
  November 9, 2008
  February 8, 2009
   May 24, 2009
  September 27, 2009

 


          
          
         

   

Payment:  
  Check
  Visa   Mastercard  American Express
  Credit Card Number: ________________________________
  Expiration Date: __________________
  Amount: ____________

Return completed application and registration fee to:

Navy Performance Enhancement Clinic
PO Box 381
Arnold, MD 21012

Please make check payable to NAAA 

 

 

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