Cadet and Midshipmen Academy Registration Form
Continental Sloop Providence - 2006
Name:____________________________________________
Date of Birth: __________________
Grade:__________School:_______________________________
Week Choices:________________________________________
Name of Guardian or Parent:____________________________
Relationship:__________________________________________
Address: _____________________________________________
City:________________State:______ Zip: __________
Home Phone:______________________________________
Work Phone:______________________________________
Email:____________________________________________
Please return this form and a 50% deposit to register
Tuition is $ 850 (per week) for Cadets,
$900.00 (per week) for Midshipmen
Total amount enclosed:___________
Upon receipt we will send you a complete Cadet packet, information sheet, and emergency medical form.
The PMHF accepts checks, Visa, MasterCard and
American Express.
Card #:_______________________________________________
Exp. Date:_______-_______-_______
Name: _______________________________________________
Signature:____________________________________________
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