LONG ISLAND FREESTYLE WRESTLING CLINIC

REGISTRATION FORM

NAME ______________________________ AGE ________ SCHOOL/CLUB ____________________________

ADDRESS ______________________________________________________________

USA CARD NUMBER __________________________

PHONE NUMBER _____________________ PARENT/GUARDIAN _____________________________

EMERGENCY PHONE NUMBER _______________________ CONTACT PERSON ______________________

Wrestlers are to report to the Freeport Recreation Center on Thursday evening March 7^th at 5:30 PM

Bring workout gear and wrestling sneakers

Participants will receive a Clinic Tee Shirt

Direct questions to: (631) 587-3673

Send registration form to:

Long Island Freestyle Wrestling Clinic

531 Gwynn Street

Babylon, NY 11702