MATRIX ELITE WRESTLING SQUAD REGISTRATION FORM
MATRIX ELITE SQUAD FORM
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AGE DIVISION: BANTAM MIDGET JUNIOR INTERMEDIATE ETC.
QUALIFYING TOURNAMENT & PLACE
THIS TEAM WILL BE COMPETING AGAINST THE BEST AMERICA AND THE WORLD HAS TO OFFER.
SEND TO: Matrix Wrestling, 3546 Broadway, ALLENTOWN, PA. 18104
Grade______ Birth Date__________Age Div.__________ Weight________
Qualifying Tournaments and Places____________________________
USA CARD NUMBER:__________
I grant permission my son/daughter to participate in the Matrix Wrestling program and agree to hold harmless all coaches, officers, and the __________________School District in the event of injury, which could occur during their participation in the sport of wrestling. Further, I/ we authorize the Matrix wrestling representatives to provide emergency treatment of injury and or illnesses of my/our child if qualified medical personal consider treatment necessary. This authorization is granted only if I/we cannot be reached.
Wrestlers Signature: _____________________ Date:_________
Parent/ Guardian Signature:___________________________ Date_______________
IF YOU HAVE ANY QUESTIONS PLEASE PHONE: (610) 391-8915 ask for BILL ALLEN WEB PAGE: WWW.MATRIXWRESTLING.COM
LETTERING IS MADE DARK FOR PRINTING PURPOSES, SORRY FOR ANY INCONVENIENCE
BETHLEHEM CATHOLIC HIGH SCHOOL
2133 MADISON AVENUE, BETHLEHEM, PA. 18017
* ALL WRESTLERS MUST HAVE A CURRENT USA CARD FOR THE 2002 -03 SEASON, YOU MAY PURCHASE IT THROUGH US
* $ 10.00 DISCOUNT FOR 2ND CHILD IN FAMILY
* DISCOUNTS FOR TEAMS OF TEN OR MORE WRESTLERS - $10.00 PER WRESTLER