2017 Rocky Mountain Wrestling Camp Registration
Please complete this form. Credit Card Payment can be made by calling the number below:

11759 Groat Road
Edmonton, AB
T5M 3K6

Email: aawa@ocii.com
Telephone: (780) 415-0140
Fax : (780) 422-2663
http://albertaamateurwrestling.ca

If applying to the NCCP Coaching Courses, *IN ADDITION* to completing this registration page, please login to "The Locker" or create a new account on www.coach.ca and register for each module you are taking at the following links on the NCCP calendar:

Community Coach: https://thelocker.coach.ca/event/public/5181063

Intro To Comp Part 1: https://thelocker.coach.ca/event/public/5181066

Intro To Comp Part 2: https://thelocker.coach.ca/event/public/5181067

Attending Which Program?
Required
Are You Taking The Provided Bus From Edmonton ($100 Return)
Which Activity Are You Interested In on Activity Day?
Last Name
Your answer
First Name
Your answer
Gender
Mailing Address
Your answer
City
Your answer
Province
Your answer
Postal Code
Your answer
Date Of Birth
MM
/
DD
/
YYYY
Phone Number
(xxx)xxx-xxxx
Your answer
E-Mail Address
Your answer
Years Experience
Your answer
Wrestling Club/School
Your answer
Coach
Your answer
Weight (kg)
Your answer
Emergency Contact
Your answer
Relationship To Athlete/Coach
Your answer
Emergency Contact Phone
(xxx)xxx-xxxx
Your answer
Provincial Health Card #
Your answer
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