Place:

Cottonwood/Mingus Union Wrestling Clinic

May 21 - 22, 2008

TEAM MIDWEST EXTREME WRESTLING CAMPS

Registration for Cottonwood/Mingus Union 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 Mingus Union 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:

-- Tom Wokasch at (928) 639-0744 or e-mail tw@muhs.com

-- Rob Szmanda at (608) 397-6116 or e-mail robmanda1@hotmail.com

-- 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 Tom Wokasch, c/o Mingus Union High School, 1801 East Fir Street, Cottonwood, AZ  86326.  All pre-registration forms are due by May 20, 2008.  Checks should be made payable to:  EAGLE EXTREME WRESTLING CLUB.

WHO:

time:

cost:

Mingus Union High School  (Located in Cottonwood, AZ)

Wrestlers in grades 5-12

3:00 - 5:30 p.m.

$65

Camp fee includes T-shirt.

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