Camp Application Form                                                                         Download PDF
Name:     Address: 

City:        State:   Zip:
Parents Home Phone   Cell Phone
Parents Work Phone Email:
Age Grade in Sept 2012 Weight
High School                Coach
Requested Roommate
Resident Camper  Commuter Camper
     
Check the camp(s)  you will attend in 2012:   
June 15 -17 Parent & Child Weekend $250 for Both P & C/$65 for a second child
June 27-July 1 Team Camp $300 Res./$215 Com.
   13 or more campers from the same school get $10 discount per camper.
June 27-July 1 Technique Camp $270 Res/$195 Com.
If you select to mail this application.  You must print out the application prior to hitting the submit form, otherwise the information will be processed.  Send payment and application to Roger W Crebs Warrior Wrestling Camp, Lycoming College 700 College Place Campus Box 143  Williamsport PA 17701.  Please include a non-refundable deposit of $75.  Make checks payable to Warrior Wrestling Camp.
   
Liability Release:  By filling out and submitting this application, I hereby release and hold harmless Lycoming College, the Warrior Wrestling Camps, their owners, agents, and employees of and from all causes, liabilities, damages, claims, or in the course of competition and/or activities held in connection with the sport camp.

I understand that a camper who does not abide by the rules and regulations promulgated by the camp or college is subject to dismissal without reimbursement or recourse.

Signature

Please type your name in the box provided above.  If the above signed is under 18 years old, the box must contain the name of a parent or guardian.


Leave Any Comments or Questions for Head Wrestling Coach Roger Crebs
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Lycoming College - 700 College Place   Williamsport, PA 17701 -  PH:  570-321-4264 -  Email: crebs@lycoming.edu