Wrestling Team Camp 3 Registration - pay by credit card

July 17-20, 2016

Registration deadline: July 6, 2016

Please make a copy of your completed registration form and give it to your coach or team representative, along with a copy of your email confirmation of payment, which you will receive after submitting this form.

* = required field

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NOTE: Campers MUST have proof of health insurance (photocopy of insurance card) AND completed health form provided to Luther College BEFORE check-in in order to participate in our camps.
First Name*
Last Name*
Address*
City*
State*
Zip code*
Home phone
Camper's cell phone
Camper's e-mail
Parent's Name(s)*
Parent's cell phone
Parent's e-mail*
Grade next fall*
School*
Coach's name*
Birth date (MM/DD/YYYY)*
Age*
Height*
Weight*
HS Graduation Year
State Tournament Honors
2015-2016 Season Record
Approximate High School GPA (optional)
Possible College Major (optional)
T-shirt Size*
Refund Policy: Written or e-mailed cancellation notice that is received ten or more business days prior to the first day of camp will result in a full refund, less a $50 cancellation fee.
Attending*
Attending as*
Payment Amount*
Name as it appears on card
Billing Street Address
City
State/Province
Zip/Postal Code
Country