Conference Online Registration Form

WORLD HOOPS CLINIC

ONLINE REGISTRATION FORM
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
School/Club
YesNo
Registration Fee Php 6,000.00

Payment can be made at:

EAST WEST BANK

Account Name

HOMER DARIUS BAUTISTA/CHBL SPORTS TRAINING CENTER

Account Number

200017293582

Please take a photo of the bank deposit slip and email to: worldhoopsclinicph@gmail.com for confirmation.

We advice that you keep the deposit slip in your safe possession to be presented on the event.
Should be Empty: