Wrestling Technique Camp June 5th and 6th 2006

Featuring: Jared Picket
College: 2x NAIA National Qualifier for Morningside College
High School: 2004 graduate of David City High School. Jared was a 3x state tournament place winner, 2x finalist, state champion, a 3x district champion, and a 2x conference champion during four-year varsity career. Posted a 121-34 career record.

Jake Stevens
College: 2x NAIA national placer (4th 2005 & 2006) for Morningside College
High School: 2004 graduate of Boone Central High School. Jake was a 3x state tournament qualifier and a 2x state placer. Posted a career record of 96-43.

SESSION 1: 9:30a.m. – 11:00 a.m.
K-6th GRADE WRESTLERS (5TH -6TH NOVICE)
SESSION 2: 12:00 p.m. – 4:00 p.m.
5th-12th GRADE WRESTLERS (5TH-6TH EXPERIENCED)

Cost: Session 1 - $15.00
Session 2 – $30.00

Registration: Register either by mail or e-mail.

Payment: Make checks payable to Randolph Jr. Wrestling.

Mail To: Chad Schumacher
PO Box 183
Plainview, NE 6769

E-mail: ccschumacher@plvwtelco.net

Phone: Chad Schumacher (402) 582-3398

Please sign and return the lower portion of this letter with your check.

Liability waiver: By signing this form we hereby give permission for _______________________________________________ to participate in the Randolph Jr. Wrestling Camp. We release from liability and responsibility Randolph High School, the Randolph Junior Wrestling Club, helpers, officials, directors, any and all other agents involved with this tournament and school in case of accident, injury or death. I hereby authorize medical treatment administered by licensed medical personnel, in case of injury or accident. Additionally Randolph High School, the Randolph Junior Wrestling Club, helpers, officials, directors, any and all other agents involved are not responsible for loss or theft of items.

Name ______________________________ Grade ______ Session ____ $ __________
Address _______________________________ City _______________ Zip _________
Home Phone _____________________ Work Phone ___________________________
Emergency contact ___________________________ Phone _____________________
Wrestlers Signiture ___________________________________________ Date ______
Parent Signature _____________________________________________ Date ______