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Team Name
Town
Affiliated School
Coach
Email
Phone

ROSTER
Weight	Grade	Wrestler's Name
45#
50#
55#
60#
65#
70#
75#
80#
84#
88#
93#
102#
115#
130#
HWT (215 max)
80#
90#
100#
110#
120#
130#
140#
160#
HWT (235 max)
#
HWT (235 max)

ALTERNATES
Weight	Grade	Wrestler's Name







HOTEL INFORMATION
Name of your hotel:

PAYMENT INFORMATION
Card type
Card number
Expiration
Billing ZIP Code

If a team is found to have a wrestler on the team roster that does not qualify to be there, that team will be disqualified for the current year plus one additional year following the infraction! It is the coach's responsibility to ensure that the roster is correct. By submitting this application, you agree that the roster is correct. Entry fee is $.

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