2012
Ogallala, Ne 69153
Open to K-12 grade wrestlers
Entry fee for camp $35.00
T- Shirt Included for wrestlers who Pre-Register
Check-in/ Registration HS GYM (
Tim Crocker
time
Ne State Champion 3yrs at
Master of the Twister
………………………………………………………………………………………………………………………
Pre-registration is recommended. Please send registrations to:
Jane Diaz: janediaz@opsd.org Fax 308-284-3869
ATTN: Wrestling Camp
Ogallala Ne. 69153
Checks made out to: Ogallala Wrestling Camp
Wrestler’s Name____________________________________________________
Wrestling Club_________________________ School____________________________
Home Address________________________________ City_______________________
2012-13 Grade________Age_______Weight__________
Parent/Guardian Name______________________________
Contact Phone #___________________
Have 2011-12 AAU card#__________________ Do not have 2011-12 AAU card_______
Wrestlers T-shirt size _________________________________
Liability Waiver: In consideration of you accepting this application, I hereby for myself, my heirs, my executors and administrators, waive and release any and all injuries suffered by me at or in connection with the 2012 Battle at Big Mac Wrestling Camp & Tournament, Ogallala Public School District, Ogallala High School, Dano Stokey, Byron Korf, UNK clinicians, and volunteers.
___________________________________ ___________________________
Parent/Guardian Signature Date




