Complete the form below or call us with your questions, and we'll talk you through the booking process. Then, we'll work with you to schedule a BREAKout! Swim Clinic with a pair of outstanding athletes, help you promote the clinic, even give you ideas on fundraising.

Don't wait; dates are filling up. Schedule your clinic in 2008 and be part of The 100 Club Tour!

Call 210-494-9671 or complete the form below.
* required field

* Name:
Address:
City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP:
* E-mail:
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Are you a:	Swimmer Coach Board Member
How did you hear about us:	- select - Splash Magazine USA Swimming's Web Site Flyer Coach Other
Swim Club Name:
Is it a USA Swimming club?:	Yes  No
What time of year or specific date are you interested in?	- select - January February March April May June July August September October November December
How many swimmers are in the club?
Has an elite athlete visited your program?	Yes   No
How many clubs and swimmers are within 25 miles?
Who are your top three choices for clinicians	1. 2. 3.
What is your closest airport?
YES, Please send me a copy of the promotional DVD! (Please make sure you've completed the address fields above)