
Cadet and Junior National Dual Team
2003 Application
Chuck
Bullard State Chairman
For Questions contact:
(360) 297-8494 phone (360) 297-1695
fax ChuckBullard@earthlink.net
The following MUST be included with
application or it will be returned:
1)
Complete and
signed Application
2)
Cashiers Check or
Money Order for $350.00 (no personal checks and no cash) Make payable
to: WSWA or Washington State Wrestling
Association - $330.00 to be refunded within one week if you do not make team.
3)
Code of Conduct
Form SIGNED
4)
Copy of current
year USA Wrestling Card
5)
Copy of Birth
Certificate
6)
Complete and Signed
Dual Team Entry Form Ensure it is the correct form they are different
between the Cadet and Junior Team
7)
Sizes Specified:
a.
Jacket Size
b.
Tee Shirt Size
c.
Short Size
ANY spots not filled will be selected
and filled by the coaching staff.
Application Registration Form
Name
Name for airline ticket if
different than above
Mailing Address
City State Zip Code
Phone (include area code)
Weight
Signature of Athlete
Signature of Parent and/or
Guardian
Print Name of Parent and/or
Guardian
Mark all that you are
competing for: Cadet Team Junior Team
Tom Shaw Northwest Regionals Placing:
Cadet Freestyle Cadet
Greco Roman
Junior Freestyle Junior Greco Roman
Cadet Greco Roman Junior Greco Roman
Cadet Freestyle Junior Freestyle
West Junior Regionals (
Junior Freestyle Junior Greco Roman
Previous Year Dual Team Member:
Cadet Junior
Previous Year National Team Member:
Cadet Junior
Previous Year All American Placing:
Cadet Greco Cadet Freestyle
Junior Greco Junior Freestyle
Previous Year National Champion:
Cadet Greco Cadet Freestyle
Junior Greco Junior Freestyle