Carl Adams Wrestling: Sign Up Now

Online Sign Up Application

Full Name

Street Address

Address Line 2

City

State/Province

Zip/Postal Code

Email address

Location

Camp

Commuting?

Format

Age

years

Current Weight

lbs

Years Involved in
Organized Program

years

Grade Entering
Next Year

Transportation
Credit?

[?]

Family Discount?

[?]

Team Discount?

[?]

Sections Below to Be Completed By Applicant's Parent or Legal Guardian

Home Phone

- -

Emergency Number
Other Than Home

- -

Health Insurance Co.

To complete this application, a parent or guardian must pay a non-refundable deposit and authorize medical treatment.

The parent or guardian authorizing must be the same one named on the credit card used to pay the deposit.

The 21-Day Camp requires a $250 deposit; the 12-day sessions require a $150 deposit; the 5 and 7-day sessions require a $100 deposit.

		Check here to indicate you have read and agree to the camp requiements

		"In case of injury or illness, I authorize treatment. I am the applicant's legal parent or guardian" (check to indicate agreement)

Name on Credit Card

Card Number

Credit Card Type

Expires

To submit this application and have your credit card charged as detailed above, click this button ONCE
(do not double-click or your order will be submitted twice!)

Enroll Early to Reserve Your Space!

24-Day Camp:
Only 100 students will be accepted.

All other camps:
Only 50-200 students will be accepted for each session.

Your information is secure and your privacy assured.

The Asics Instutute will not sell or share your information.

If you prefer, you may also print out this form and mail it.



	For complete information on all formats, or to request a brochure, call , fax, or write Carl Adams	Copyright © 2008 Carl Adams
	This camp must be certified by Massachusetts Health Inspectional Services Department	sitemap

Online Sign Up Application

To submit this application and have your credit card charged as detailed above, click this button ONCE (do not double-click or your order will be submitted twice!)

Your information is secure and your privacy assured.

The Asics Instutute will not sell or share your information.

To submit this application and have your credit card charged as detailed above, click this button ONCE
(do not double-click or your order will be submitted twice!)