REGISTRATION 2018/2019

* Indicates required field

NEW OR RETURNING WRESTLER? *

USA WRESTLING CARD NUMBER (RETURNING WRESTLERS) *

T SHIRT SIZE *

EMAIL ADDRESS *

FIRST NAME *

LAST NAME *

DATE OF BIRTH (XX/XX/XXXX) *

PHONE NUMBER *

GENDER *

ADDRESS 1 *

CITY *

ZIP *

PARENT 1 FIRST NAME *

PARENT 1 LAST NAME *

PARENT 1 EMAIL *

PARENT 1 PHONE NUMBER *

PARENT 2 FIRST NAME *

PARENT 2 LAST NAME *

PARENT 2 EMAIL *

PARENT 2 PHONE NUMBER *

I have read and agree to the terms of the Medical and Liability Release Waiver *

Submit

Location-
500 N. Adams
Lebanon, MO