Form

FVBC - 2011/2012 CLUB FEES - INSTALLMENTS
Name*
First Name Middle Name Last Name
E-mail*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*
- Area Code Phone Number
SCHEDULE*
13U & OLDER: DEPOSIT - DEC/2011 Parents Meeting $350.00 USD
13U & OLDER: Due JAN/15/2012 $200.00 USD
13U & OLDER: Due FEB/15/2012 $145.00 USD
12U: DEPOSIT - 12/2011 Parents Meeting $350.00 USD
12U: Due JAN/15/2012 $200.00 USD
12U: Due FEB/15/2012 $75.00 USD
Player/Coaches Clinic: Dec 9-10 $35.00 USD

Player/Coaches Clinic: Dec 9-10

Total: $0.00 USD
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