MIDWEST EXTREME WRESTLING

Place:

Loyal Wrestling Clinic

July 30 - August 1, 2008

TEAM MIDWEST EXTREME WRESTLING CAMPS

Registration for Loyal 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 Loyal 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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Registration Form
Loyal

For More Information, Please contact either of the following:

-- Shawn Verhulst at (715) 429-0720 or e-mail at shiver60@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 Shawn Verhulst, 405 East First Street, Apt. C, Loyal, WI  54446.  All pre-registration forms are due by July 29, 2008.  Checks should be made payable to:  EAGLE EXTREME WRESTLING CLUB.

WHO:

time:

cost:

Loyal High School

Wrestlers in grades 3-12

$60

Camp fee includes T-shirt.

Dates

Wednesday, July 30

Thursday, July 31

Friday, August 1

Time

6:00 - 8:00 p.m.

6:00 - 8:00 p.m.

5:30 - 7:30 p.m.