2002 LOCK HAVEN FALL CLASSIC ENTRY FORM

2005 LOCK HAVEN FALL CLASSIC ENTRY FORM

(please print and fill in all information)

NAME:
ADDRESS:
CITY/STATE/ZIP:
TELEPHONE (with area code):
GRADE:	AGE:
DATE OF BIRTH:
HIGH SCHOOL / COLLEGE:
IMPORTANT: MUST BE COMPLETED!
DIVISION:	WEIGHT:

I hereby give this athlete permission to wrestle in the 2005 Lock Haven Fall Classic and release all sponsoring bodies, their officers, tournament officials, committees and referees for all liability.

______________________________	______________________________
Parent / Guardian Signature	Contestant Signature

Preregistration Entry Fee: $20.00 per person / per division
In order to be classified a Preregistration Entry, the application must be postmarked no later than October 10, 2005.
Walk-On Entry Fee: $25.00 per person / per division

MAKE ALL CHECKS PAYABLE TO:
CENTRAL MOUNTAIN WRESTLING ASSOC.

PRINT OUT APPLICATION AND SEND WITH ENTRY FEE TO:
LOCK HAVEN FALL CLASSIC
PO BOX 825
LOCK HAVEN, PA 17745

Entry Deadline: Must be POSTMARKED by October 10, 2005.
Walk-ons must pay the walk-on fee.