Place:

Clintonville Wrestling Clinic

July 15 - 17, 2007

TEAM MIDWEST EXTREME WRESTLING CAMPS

Registration for Clintonville Clinic

NAME:

E-MAIL ADDRESS:

ADDRESS:

CITY/STATE/ZIP:

TELEPHONE:

GRADE THIS FALL:

As the parent/legal guardian of the above named athlete, I understand and agree that the Clintonville Public Schools, the Midwest Extreme Wrestling Club and its clinicians, and anyone else connected with the facilities used assume no responsibility for accidents, injuries, medical, or dental expenses incurred by my son/daughter while participating in this program.

Parent or Legal Guardian’s Signature                                                                                       Date

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For More Information, Please contact either of the following:

-- Dan Lowney at (920) 244-7408

-- Mike Michonski at (715) 823-6968

-- Billy Huebner at (608) 790-2468                                                              

REGISTRATION:

Pre-registration is preferred but not required -- walk-ins are welcome.  If pre-registering, please complete the registration form below and send it with your camp fee to Mike Michonski, 64 North 12th Street, Clintonville, WI  54929.  All pre-registration forms are due by June 1, 2007.  Checks should be made payable to:  EAGLE EXTREME WRESTLING CLUB.

WHO:

time:

cost:

Clintonville High School

Wrestlers in grades K-12

Grades K-5

5:00 - 6:30 p.m.

$65 - Grades 6-12

$55 - Grades K-5

Note:  $80 for registrations received after June 1

Camp fee includes T-shirt.

Grades 6-12

6:30 - 8:30 p.m.

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