Raider Mat Club Wrestling Registration

Cost: $30 Registration Fee; $20 Uniform Deposit; $50 Fundraiser Pre-Pay. $100 Total
Wrestler Info
First Name
Last Name
Date of Birth
Grade
Years of Experience
Street
City
State
Zip
Weight
Height
Shirt Size
Explain any Pre-Existing Medical Conditions
 
Mother
First Name
Last Name
Home Phone
Cell Phone
Work Phone
Email
 
Father
First Name
Last Name
Home Phone
Cell Phone
Work Phone
Email
 
Other