Please complete form to register for the  Navy Performance Enhancement
Clinic.   If you would like to pay by check, please complete this form, print and mail to:

Navy Performance Enhancement Clinic
PO Box 381
Arnold, MD 21012

Participant's First Name:     
Participant's Last Name: 
Contact email address:  
Age:                        
Street Address: 
City:       
State:     
Zip:    
Telephone: