Professional Documents
Culture Documents
Ground N Pound 2012
Ground N Pound 2012
Ground N Pound 2012
Several HS teams attend these clinics and make leg riding their style of mat wrestling Lunch time will be from 12-1; each wrestler brings their own lunch Covers 11 hours of technical instruction and drilling (no refunds given, only credit for future camps)
EASY REGISTRATION? www.tonypurler.com, pay via payal, bring paypal receipt and app with you.
Camps run by Tony Purler and Asst. Coach Brett Delich. NO video cameras allowed during the clinics. Make checks payable and send registration form below to: Tony Purler, 7710 SE Moore Dr. Holt, Mo. 64048
****************************CHECK BOX for the clinic you wish to attend and detach here ****************************
June 23-24 Sat-Sun June 30-July1 Sat-Sun July 23-24 Mon-Tue July 25-26 Wed-Thu July 28-29 Sat-Sun July 28-29 Sat-Sun July 31-Aug 1 Tue-Wed Aug 4-5 Sat-Sun Aug 4-5 Sat-Sun Aug 11-12 Sat-Sun Aug 11-12 Sat-Sun Aug18-19 Sat-Sun Aug 18-19 Sat- Sun Aug 25-26 Sat- Sun
Waukee HS Nixa HS Blue Springs South HS St. James Academy High School Washburn Rural Middle School Totino Grace High School Tonys Home Training Ctr, 7710 Se Moore Dr. Savannah HS Pratt HS Andover Central HS Helias HS Francis Howell Central HS Jackson HS Papillion Vista HS 302 E Cary St Papillion,NE 68046
Des Moines, IA Nixa, MO (near Springfield) Blue Springs, MO Lenexa, KS Topeka,KS Minneapolis, MN Holt, Mo St. Joseph, MO Pratt, KS Wichita, KS Jefferson City, MO St. Charles, MO Jackson, MO Omaha, Ne
Name________________________________________ Age_________ wt._______ dob_________________ Address ______________________________City_________________________State______Zip_____________ Cell #__________________________________ Email (very important!)_________________________________________ Medical Insurance Co & Policy # ______________________________
Waiver: My son/daughter has been examined by a physician in the past year and is in good health. I hereby authorize the Clinic/ Staff to act for me, according to its best judgment in any medical emergency, and I hereby waive and release said camp from any liability for injuries or illness incurred by my son/daughter while attending camp. All information I have provided on this application is accurate. PARENT SIGNATURE_________________________________________ DATE ______________________