Summer Kick Off Clinic

For Athletes Only (This form is not for coaches. All coaches, clinicians and camp counselors must be USA Wrestling Leader members to participate in the camp).

Step 1/4: Identification

Parent/Guardian - Please input Wrestler information below

First Name *

Last Name *

Participant Date of Birth*

State * Choose State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Canada US Territory Guam

COPPA Sign Off: * I certify that I am above the age of 13 and/or I am the legal parent or guardian of the above listed athlete.