NYACE Online

Tournament Registration Form

Select a Tournament2010-09-11 - 1st Annual NJ Fallen Heroes Memorial (Age/Grade-Tourn Date)Select DivisionSelect Weight Class

Wrestler's First Name:
Wrestler's Last Name:
Team or Club Name:
Address:
Address cont.:
City:
State:
Zip Code:	-
Phone Number 1:	() -
Phone Number 2:	() -
Wrestler's Date of Birth:	Select MonthSelect DaySelect Year
Wrestler's Age (As of June 1st, 2009):
Wrestler's Grade (2008-09 School Year):
Contact Email 1:
Contact Email 2:
Wrestler's Actual Weight:
2009 - 2010 Record:	Wins   Losses
Wrestler's Level (Enter a C for Champ, FC for future Champ or N for Novice):
I heary-by declare that as a participant in this tournament I will enter at my own risk. I will not in any way hold liable the officials, coaches, hosting facilities, Polli-Shore Tournaments or its employees for any injury I may receive while in this event, or traveling to and from this event.
Parents Initials for Waiver:

No confirmation page displayed. No confirmation email will be sent. You will get an index card at weigh-ins.