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  Camp Application
Name:     Address: 

City:        State:

Zip:
 
Parents Home Phone   Cell Phone
Parents Work Phone 
Email:
Age Grade in Sept 2008 Weight
High School               

Coach
                                                      

Requested Roommate 
Resident Camper  Commuter Camper
 
   
Check the camp(s)  you will attend in 2008:  
June 20 to June 22 Parent & Child Weekend I $230 for Both P & C
June 22 to June 25 Technique Camp** $250 Res/$190 Com.
June 22 to June 25 Elementary Camp** $250 Res/$190 Com.
June 28 to July 2 Team Camp (Jr. & Sr. High) $285 Res*./$215 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.


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Phone: 570-321-4264 -  Fax: 570-321-4158 - Roger Crebs - Lycoming College  - 700 College Place, Williamsport PA 17701