Big Horn Nationals Wrestling Championships

CONTACT:_________________________ CLUB NAME:_________________________
ADDRESS LINE 1:__________________________________________________
ADDRESS LINE 2:__________________________________________________
PHONE:_________________________ FAX:_________________________
TOTAL # OF ENTREES_______________ X $37 FEE__________ = $__________

WRESTLERS
FIRST NAME

LAST NAME

BIRTHDATE

AGE

LBS

RATING

WIN

LOSS

6 And Under

 

 

 

8 And Under

 

 

 

10 And Under

 

 

 

12 And Under

 

 

 

14 And Under

 

 

 

High School

 

 

 

AA National Placer    A State Placer             B State Qualifier           C Regional Qualifier

LIST ALL NATIONAL AND STATE PLACINGS ON REVERSE SIDE OF THIS DOCUMENT
ENTRY DEADLINE: November 3, 2010
Make Checks Payable to Big Horn Nationals Wrestling Championships
Mail Entry to: Big Horn Nationals, 950 S. Kent Bdlg. C., Liberty, MO 64068