Clinic Registration: IBCA Clinic April 24-25 Lawrence North HS, Pre-Registration before April 10, 2020

• Hotel Accommodations

  
  

  *Hilton Garden Inn
  Indpls. Northeast Fishers, 9785 North by Northeast Blvd., Fishers, 46037
  Room rate is $159.00 (mention you are IBCA member)
  Reservations: 317-577-5900
  Group code: BASK
  Cut Off Date 4/1/2020
  Booking Link:
  
  *Hampton Inn
  Indpls. NE, 6817 E. 82nd St. Indianapolis 46250
  Room rate $159.00
  Reservations: 317-576-0220 cut off date 4/9/2020
  Booking Link: https://secure3.hilton.com/en_US/hp/reservation/book.htm?inputModule=HOTEL&ctyhocn=INDNEHX&spec_plan=CHHICA&arrival=20200423&departure =20200426&cid=OM,WW,HILTONLINK,EN,DirectLink&fromId=HILTONLINKDIRECT Instructions:
  -Click link
  -Confirm Dates
  -“Continue”
  -Select Room type and Book J
  
  

• Registration after April 10

  If you are signing up between April 10 and April 17 you MUST pay with a credit card. You may sign up at the clinic with a credit card or bring a check with you.
• School*
  Select SchoolOther21st Century (Gary)Adams Central HSAncilla CollegeAlexandria-MonroeAndersonAnderson HighlandAnderson Prep AcademyAnderson UniversityAndreanAngolaArgosAtticaAustinAvonBall State UniversityBarr-ReeveBatesvilleBedford North LawrenceBeech GroveBellmontBen DavisBenton CentralBethany ChristianBethel UniversityBethesda ChristianBlackfordBloomfieldBloomington NorthBloomington SouthBlue River ValleyBluffton HSBoone GroveBoonville HSBorden HSBowman AcademyBrebeuf JesuitBremenBrown CountyBrown Mackie CollegeBrownsburgBrownstown CentralButler UniversityCalumetCambridge City LincolnCalumet College of St. JosephCampagna AcademyCanneltonCarmelCarroll (Flora)Carroll (Ft. Wayne)CascadeCassCastleCastonCentral Christian AcademyCenter GroveCentervilleCentral NobleCharlestownChestertonChristian Academy of IndianaChurubuscoClarksvilleClay City HSClinton CentralClinton PrairieCloverdaleColumbia CityColumbus EastColumbus NorthConcordConnersvilleCorydon CentralCovenant Christian_DeMotteCovenant Christian_IndplsCovingtonCowanCrawford CountyCrawfordsvilleCrothersvilleCrown PointCulver AcademyCulver CommunityDaleville SchoolsDanvilleDecatur CentralDekalbDelphiDeltaDePauw UniversityDugger UnionEarlham CollegeEast CentralEast Chicago CentralEast NobleEastbrookEastern (Greentown)Eastern (Pekin)Eastern GreeneEastern HancockEastsideEdgewoodEdinburghElkhart CentralElkhart Christian AcademyElkhart MemorialElwoodEminenceEvansville BosseEvansville CentralEvansville ChristianEvansville Day SchoolEvansville F.J. ReitzEvansville HarrisonEvansville Mater DeiEvansville NorthEvansville Reitz MemorialFall Creek AcademyFarifield HSFishersFloyd CentralForest ParkFountain CentralFW Bishop DwengerFW Bishop LuersFW Blackhawk ChristianFW CanterburyFW Concordia LutheranFW ElmhurstFW North SideFW NorthropFW SniderFW South SideFW WayneFountain CentralFrankfortFranklin CentralFranklin CollegeFranklin CommunityFranklin CountyFranktonFremontFrontierGarrettGary RooseveltGary WallaceGary West SideGary WirtGibson SouthernGlennGoshenGoshen CollegeGrace College & SeminaryGreencastleGreenfield-CentralGreensburgGreenwood ChristianGreenwoodGriffithGuerin CatholicHagerstownHanover CollegeHamiltonHamilton HeightsHamilton SoutheasternHammondHammond AcademyHammond Bishop NollHammond ClarkHammond GavitHammond MortonHanover CentralHardingHarrison(West Lafayette)HauserHebronHenryvilleHeritageHeritage ChristianHeritage HillsHighlandHobartHoly CrossHoly Cross CollegeHomesteadHowe MilitaryHuntington UniversityHuntington NorthIlliana Christian (Dyer, IN)Indiana Institute of TechnologyIndiana UniversityIndiana University EastIndiana University KokomoIndiana University NorthwestIndiana University South BendIndiana University SoutheastIndiana University - Purdue University Columbus (IUPUC)Indiana University - Purdue University Fort Wayne (IPFW)Indiana University - Purdue University Indianapolis (IUPUI)Indiana WesleyanIndiana CreekIndianapolis ArlingtonIndiana School for the BlindIndianapolis Gambold PrepIndiana School for the DeafIndiana State UniversityIndpls. ArlingtonIndpls. Arsenal TechnicalIndpls. Bishop ChatardIndpls. Broad RippleIndpls. Cardinal RitterIndpls. CathedralIndpls. Crispus AttucksIndpls. Emmerich ManualIndpls. HerronIndpls. Howe AcademyIndpls. LutheranIndpls. MetropolitanIndpls. NorthwestIndpls. Scecina MemorialIndpls. WashingtonInternational School of IndianaJac-Cen-DelJasperJay CountyJeffersonvilleJennings CountyJimtownKankakee ValleyKaplan CollegeKeystoneKnightstownKnoxKokomoKoutsLaCrosseLafayette Central CatholicLafayette JeffersonLake CentralLake Station EdisonLakelandLakeland Christian AcademyLakewood Park ChristianLanesvilleLapelLaPorteLaVilleLawrence CentralLawrence NorthLawrenceburg HSLebanonLeoLiberty ChristianLighthouse CPA South(Indpls)Lighthouse CPA (Bloom)Lighthouse CPA (Gary)Lighthouse East (Anderson)Linton-StocktonLogansportLoogooteeLowell HSMaconaquahMadison Consolidated HSMadison GrantManchesterManchester CollegeManchester University (Indiana)Marian UniversityMarionMarion Lakeview ChristianMartin UniversityMartinsvilleMarquette CatholicMcCutcheonMedoraMerrillvilleMichigan CityMichigan City MarquetteMilanMishawakaMishawaka MarianMississinewaMitchellMonroe CentralMonroviaMooresvilleMorgan TownshipMorristownMorton MemorialMt VernonMt Vernon(Fortville)Muncie BurrisMuncie CentralMuncie SouthsideMunsterNew AlbanyNew CastleNew HarmonyNew HavenNew PalestineNew PrairieNew WashingtonNoblesvilleNorth Central (Farmersburg)North Central (Indpls.)North DaviessNorth DecaturNorth HarrisonNorth Judson-San PierreNorth KnoxNorth MiamiNorth MontgomeryNorth NewtonNorth PoseyNorth PutnamNorth VermillionNorth WhiteNortheast DuboisNortheasternNorthfieldNorthridgeNorthviewNorthwesternNorthwoodNorwellNotre Dame UniversityOak HillOakland City UniversityOakland City Wood MemorialOldenburg AcademyOregon-DavisOrleansOwen ValleyPaoliParke HeritagePark TudorPendleton HeightsPennPerry CentralPerry MeridianPeruPikePike CentralPioneerPlainfieldPlymouthPortagePrairie HeightsPrinceton CommunityProvidenceProvidence Cristo ReyPurdue UniversityPurdue University CalumetPurdue University North CentralPurdue University College of TechnologyRandolph SouthernRensselaer CentralRestoration ChristianRichmondRising SunRiver ForestRiversideRiverton ParkeRochesterRock Creek AcademyRoncalliRose HulmanRose-Hulman Institute of TechnologyRossvilleRushville ConsolidatedSaint Joseph's CollegeIndianaSaint Mary-of-the-Woods CollegeSaint Mary's CollegeSalemScottsburgSeegerSeton CatholicSeymourShakamakShawe MemorialShelbyvilleShenandoahSheridanShortridgeShoalsSignatureSilver CreekSmith Academy (Fort Wayne)South AdamsSouth Bend Career AcademySouth Bend AdamsSouth Bend ClaySouth Bend RileySouth Bend St. JosephSouth Bend WashingtonSouth Central (Elizabeth)South Central (Union Mills)South DearbornSouth DecaturSouth KnoxSouth NewtonSouth PutnamSouth RipleySouth SpencerSouth VermillionSouthern WellsSouthmontSouthportSouthridgeSouthwestern (Hanover)Southwestern (Shelbyville)SouthwoodSt. FrancisSouthern Indiana UniversitySpeedwaySprings ValleySteel City AcademySullivanSwitzerland CountyTaylorTaylor UniversityTecumsehTell CityTerre Haute North VigoTerre Haute South VigoTindleyTippecanoe ValleyTiptonTriTri -CentralTri-CountyTraders Point ChristianTrinity LutheranTrine UniversityTrinity (South Bend)TritonTriton CentralTri-West HendricksTwin LakesUnion (Dugger)Union (Modoc)Union CityUnion CountyUniversity of EvansvilleUniversity of IndianapolisUniversity of Saint FrancisUniversityValparaisoValparaiso UniversityVictory Christian Academy (Valpo)Vincennes LincolnVincennes RivetVincennes UniversityWabashWabash CollegeWaldronWapahaniWarren CentralWarsawWashingtonWashington CatholicWashington TwpWawaseeWes-DelWest CentralWest LafayetteWest NobleWest VigoWest WashingtonWestern (Howard County)Western BooneWestfieldWestviewWestvilleWheelerWhite River ValleyWhitelandWhitesWhitingWhitkoWinamacWinchesterWoodlanYorktownZionsville
• Address*
  Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
• Title*
  • Boys or Girls Coach
  • Media Rep
  • Official
  • Former Coach
• Email*
• District*
  Select One123Other

• Coaches Attending Clinic

• How many coaches are attending the clinic?*
  Select One123456
• Name*
  First Last
• Coaching Level*
  Select OneHS Boys Head CoachHS Ast. Boys Coach (9-12)HS Head Girls CoachHS Ast. Girls Coach (9-12)JR High School CoachElementary CoachCollege CoachFormer CoachMediaOfficialIBCA District RepIBCA Board of DirectorsIBCA Assistant DirectorIBCA Executive DirectorIBCA Assoicated Executive DirectorOther
• Membership Number
• Fee*
  Select OneMember Fee- $50Non-Member Fee- $100
• Name*
  First Last
• Coaching Level*
  Select OneHS Boys Head CoachHS Ast. Boys Coach (9-12)HS Head Girls CoachHS Ast. Girls Coach (9-12)JR High School CoachElementary CoachCollege CoachFormer CoachMediaOfficialIBCA District RepIBCA Board of DirectorsIBCA Assistant DirectorIBCA Executive DirectorIBCA Assoicated Executive DirectorOther
• Membership Number
• Fee*
  Select OneMember Fee- $50Non-Member Fee- $100
• Name*
  First Last
• Coaching Level*
  Select OneHS Boys Head CoachHS Ast. Boys Coach (9-12)HS Head Girls CoachHS Ast. Girls Coach (9-12)JR High School CoachElementary CoachCollege CoachFormer CoachMediaOfficialIBCA District RepIBCA Board of DirectorsIBCA Assistant DirectorIBCA Executive DirectorIBCA Assoicated Executive DirectorOther
• Membership Number
• Fee*
  Select OneMember Fee- $50Non-Member Fee- $100
• Name*
  First Last
• Coaching Level*
  Select OneHS Boys Head CoachHS Ast. Boys Coach (9-12)HS Head Girls CoachHS Ast. Girls Coach (9-12)JR High School CoachElementary CoachCollege CoachFormer CoachMediaOfficialIBCA District RepIBCA Board of DirectorsIBCA Assistant DirectorIBCA Executive DirectorIBCA Assoicated Executive DirectorOther
• Membership Number
• Fee*
  Select OneMember Fee- $50Non-Member Fee- $100
• Name*
  First Last
• Coaching Level*
  Select OneHS Boys Head CoachHS Ast. Boys Coach (9-12)HS Head Girls CoachHS Ast. Girls Coach (9-12)JR High School CoachElementary CoachCollege CoachFormer CoachMediaOfficialIBCA District RepIBCA Board of DirectorsIBCA Assistant DirectorIBCA Executive DirectorIBCA Assoicated Executive DirectorOther
• Membership Number
• Fee*
  Select OneMember Fee- $50Non-Member Fee- $100
• Name*
  First Last
• Coaching Level*
  Select OneHS Boys Head CoachHS Ast. Boys Coach (9-12)HS Head Girls CoachHS Ast. Girls Coach (9-12)JR High School CoachElementary CoachCollege CoachFormer CoachMediaOfficialIBCA District RepIBCA Board of DirectorsIBCA Assistant DirectorIBCA Executive DirectorIBCA Assoicated Executive DirectorOther
• Membership Number
• Fee*
  Select OneMember Fee- $50Non-Member Fee- $100
• Total
  $0.00

• Payment

• How would you like to pay*
  Select OneOnlineBy Mail
• Credit Card*
  Discover

  MasterCard

  Visa

  Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date   Security Code Cardholder Name
• If paying by mail before April 10
  MAIL TO: Renee Turpa IBCA Assistant Dir. 252 Glendale Valparaiso, IN 46383