Wrestling Camp Registration Form

Fill out registration below

Camper’s Name ______________________________________________________

Parental Contact _____________________________________________________

Street Address ______________________________________________________

City___________________________ State _________ Zip ___________________

Home Ph __________________________ Day Ph ___________________________

Parent’s Email _______________________________________________________

Grade Completed by June ’12________________Age____________________

School Attending _____________________________________________________

Years wrestling experience _____ Roommate Preference__________________________

Weight Class in ’11-’12 (circle one):
103 or below 112 119 125 130 135 140 145 152 160 171 189 215 Hwt

Adult T-shirt Size (circle one): S M L XL XXL

Early Bird Discount requires full payment before May 11th. NIU Employees always qualify for the 10% discount

Camp Registration (check appropriate boxes) Full / Early Bird or Group Discount (5+ on 10 day and 10+ on Team or Individual)

__Iron Huskie 10-Day Training Camp Resident July 6-July 15 $785 / $750
__10-Day Training Camp Commuter (day camper) July 6-15    $685 / $625

__Individual Camp Resident July 11-15 $385 / $365
__Individual Camp Commuter (day camper) $285 / $265

__Team/Competition Camp Resident July 11-15th  $385 /  $365
__Team/Competition Camp Commuter (day camper) $285 / $265
__Team Camp Coach Free!

Camp Registration Total $_____________

A $50 non-refundable deposit is due with your application if not paying in full. Deposit will be applied toward camp balance, due prior to check-in.

Amount enclosed $___________ (Make checks payable to NIU)

Mail to: NIU Huskie Sport Camps
219 Convocation Center
DeKalb, IL 60115

To pay with a credit card, register online at: www.niuwrestlingcamps.com