2012 A P P L I C A T I O N
Thanks for your interest in our wrestling camps!

* Indicates Required Fields



*I wish to enroll in:
Camp Name Deposit Cost                Date               
Missouri Technique $195
$405 Resident
$305 Commuter
$200 Parent
 June 10-14
Missouri Team $195
$405 Resident
$305 Commuter
$200 Parent
 June 10-14
Missouri Youth $195 $405 Resident
$305 Commuter
$200 Parent		 June 10-14
Virginia I Technique $195 $405 Resident
$305 Commuter
$200 Parent		 June 17-21
Virginia I Team $195 $405 Resident
$305 Commuter
$200 Parent		 June 17-21
Virginia II Technique $195 $405 Resident
$305 Commuter
$200 Parent		 June 24-28
Virginia II Team $195 $405 Resident
$305 Commuter
$200 Parent		 June 24-28
Virginia II Youth $195 $405 Resident
$305 Commuter
$200 Parent		 June 24-28
Virginia II
Fargo Training		 $195 $405 Resident
$305 Commuter
$200 Parent		 June 24-28
Virginia III Technique $195 $405 Resident
$305 Commuter
$200 Parent		 July 8-12
Virginia III Youth $195 $405 Resident
$305 Commuter
$200 Parent		 July 8-12
Virginia III
Fargo Training		 $195 $405 Resident
$305 Commuter
$200 Parent		 July 8-12


*Camper Name *Address
*City *State
*Zip Code *Email
*Parent/Guardian Name
(first) (last)
*Home Telephone *Work
  (format)   111   111-1111   111   111-1111
*School Attending
*Grade Next Year      *Age *    *Weight
*10 & Under campers must have adult supervision
 
Health Information
*Health Insurance Company
*Policy Number(s)
*Please charge a deposit of : $
You may pay more than the minimum deposit shown or pay the the full amount of $.
A balance of $ is Due Prior to Start of Camp.
PlEASE NOTE THAT YOUR $195 DEPOSIT & ANY BALANCES PAID ARE NON-REFUNDABLE.
The student, parent or guardian of the student, the applicant for and in consideration of the Granby School of Wrestling, Inc., accepting said applicant, hereby agrees to save and indemnify and keep harmless the said Granby School of Wrestling, Inc., its agents, and sponsors, against any and all liability claims, judgements or demand for damages arising as a result of injuries by the applicant traveling to and from Hampden-Sydney College, Missouri Military Academy and during his stay at the school grounds, or while wrestling or taking instruction in wrestling.

I approve of my son’s attendance at wrestling camp and certify that he is in good health and able to participate in all camp activities. If medical attention is required for illness or injury while attending camp, I give my permission for such care.

*I agree to the terms listed above