Todays Date *

MM

DD

YYYY

Wrestler Information *

First Name

Last Name

Wrestlers Birth Date *

MM

DD

YYYY

Parent / Guardian #1 *

First Name

Last Name

Phone *

(###)

###

####

Parent / Guardian #2

First Name

Last Name

Phone

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

*

I/We read and agree that there are NO REFUNDS ON REGISTRATION FEES

Agree

*

By checking this box you acknowledge that you will bring a current USA Wrestling Card to practice on the first day. Directions to purchase a USA Wrestling Card can be found on the home page of the All-Phase Wrestling website

Agree