APPLICATION

Name___________________________________________________
Address_________________________________________________
City______________________________ Zip___________________
Age________ Weight________ Years Experience________
Home Phone________________________________
Emergency Phone____________________________

I approve of my son's/daughter's participation in the Next Level Wrestling Camp. I certify that my son/daughter is in good health and understand that Next Level Wrestling Camp staff, River Hill High School, or River Hill Booster are not liable for injuries and accidents that might occur during participation in our camp.

Parent Signature_______________________________________

Mail Application to:

Next Level Wrestling Clinic
8503 Falls Run Rd., Aprt. I
Ellicott City, MD, 21043

Make Checks payable to Brandon Lauer ($200)

DO NOT MAIL AFTER: July 1st, 2008
Walk-in Registration will be accepted, space permitting
NO REFUNDS AFTER CAMP BEGINS!!!