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12/22 Joe Tholl - Registration-Payment Form
*
Wrestlers FIRST Name:
*
Wrestlers LAST name:
*
Email Address:
*
Contact Phone Number:
*
Select the Division wrestler will be competing in:
ELITE Division
OPEN Division
*
Elite/ Open Weights -:
46
49
52
55
60
64
69
74
79
84
90
96
103
110
118
126
135
144
154
164
176
188
215
275
* indicates required fields
SELECT FEE
$40 - Elite Division - Open Division
Core Flooring Inc.
10802 Joliet Street, Saint John, IN 46373
219.323.4804
www.corefloorings.com