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MATRIX ELITE WRESTLING SQUAD REGISTRATION FORM

MATRIX ELITE SQUAD FORM
E-mail us, CLICK HERE >
INCLUDE:
NAME
ADDRESS
WEIGHT CLASS
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  

Name:_______________________________________                         
Address:______________________________City____________________________   
State__________Zip:___________Telephone____________________
E-mail Address:________________________________
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
E-mail: mailto:matrixmatclub@yahoo.com  

LETTERING IS MADE DARK FOR PRINTING PURPOSES, SORRY FOR ANY INCONVENIENCE
* WHERE:  
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