Crown City Wrestling Club Registration
Wrestler's Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Grade
Please Select
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Open
School:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
First Name
Last Name
Parent's Phone Number
Please enter a valid phone number.
Parent's email
example@example.com
My Products
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7-12 grade
yearly membership
$
250.00
Quantity
1
2
3
4
5
6
7
8
9
10
Advanced Youth/Youth
yearly membership
$
200.00
Quantity
1
2
3
4
5
6
7
8
9
10
Family rate
$120/wrestler for yearly
$
175.00
Quantity
1
2
3
4
5
6
7
8
9
10
Shirt Size
Please Select
YS
YM
YL
YXL
AXS
AS
AM
AL
AXL
AXXL
Waiver of Liability Completed?
Yes
No
Code of Conduct Completed?
Yes
No
Wrestler Medical Concerns
Parent/Guardian Signature
Date
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: