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Broomfield Eagle Wrestling
2022 Spring Season $180 plus USA card
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Wrestlers Name
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Wrestlers Birthdate
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MM
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DD
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YYYY
Wrestlers Address
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Parent #1 Name ( primary contact)
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Parent #1 Cell Phone
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Parent #1 Email Address
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Parent #2 Name
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Parent #2 Cell Phone
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Parent#2 Email Address
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Does the Wrestler have a medical condition we should know about?
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no
Yes
If yes to above questions please list below
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Wrestler Shirt size
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YXS
YS
YM
YL
YXL
AS
AM
AL
AXL
AXXL
Wrestler Short Size
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YXS
YS
YM
YL
YXL
AS
AM
AL
AXL
AXXL
Wrestler USA Membership Number
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How will you registration fee? ($185.00)
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Would like to order a club Singlet $70
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