2026 KHSBCA Dual Registration Form

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Please fill out ALL sections

Section A: School Name *

Section B: Head Coach & Email *

Section C: Assistant Coach(s) & Emails (Write none if individual membership only) *

Section D: School Membership ONLY Options ( All options include dual membership with NHSBCA YOU CAN ADD CONVENTION FEES IN THE NEXT SECTION *

School Membership Includes 4 Total Coaches $145

School Membership Includes 5 Total Coaches $160

School Membership Includes 6 Total Coaches $190

School Membership Includes 7 Total Coaches $205

School Membership Includes 8 Total Coaches $220

School Membership Includes 9 Total Coaches $235

Individual Membership $40

Section E: How many coaches are attending the clinic (This amount will be added to school membership fee) *

0 coaches attending

1 coach attending add $90

2 coaches attending add $180

3 coaches attending add $270

4 coaches attending add $360

5 coaches attending add $450

6 coaches attending add $540

7 coaches attending add $600

Required

Section F: Total Payment - Add amount marked in "Section D" (school membership) with amount marked in "Section E" (coaches attending clinic) and type in. This is the amount due EX: SCHOOL MEMBERSHIP WITH 5 COACHES ON STAFF IS $160 (Sec D) PLUS 3 COACHES ATTENDING CONVENTION IS AN ADDITIONAL $270 (Sec E) FOR A TOTAL OF $430 *

Section G: Payment Method *

Bringing Check/Cash/Credit Card To Convention

Mailed/Mailing In To PO Box 581202 Lou, Ky 40268

Paid/Paying via the link

Other (Please email Sherm with specifics)

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