NAME: _____________________________________________________________
CURRENT CLUB:________________________________________________________
_____Coach (USA Rugby Certified? Level_____)
_____Player ______Administrator
Did you attend 2000 Conference? _____Yes _____No
MAILING ADDRESS:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
PHONE:__________________________
DAYTIME PHONE:________________________
EMAIL:
______________________________________________________________________
2001 World Rugby Conference Shirt by "Canterbury of New Zealand"
_____Medium _____Large _____XLarge _____XX Large
PAYMENT OPTIONS
______$215 For the Conference ______$240 with extra Dinner Guest
______ Check (Payable to "New England Rugby")
For Credit Card Payment, please contact the Lake Placid Resort directly
at
1 (800) 874-1980 and ask for the "World Rugby Conference".
Please return completed form along with Payment to
Glenn Lawson
Massachusetts College
Freel Library, Suite 9250
North Adams, MA 01247-4100
this page was created by Navom Design