Wrestler Information *

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Last Name

Wrestlers Birth Date *

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DD

YYYY

Parent / Guardian #1 *

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Last Name

Phone *

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Parent / Guardian #2

First Name

Last Name

Phone

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Address *

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

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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

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Todays Date *

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DD

YYYY