Mike Krause Clinic Registration
Please complete all items on this form to register for the clinic. Use the side scroll bar to move down the form or use your tab key. Once you have completed all parts of the form, use the PayPal "Buy Now" button below to make a secure online payment with your credit card or bank account.
Wrestler's Name *
Your answer
Parent or Guardian Name *
Your answer
Full Home Address *
Your answer
Primary Phone Number *
Format (xxx) xxx-xxxx
Your answer
Primary Email Address *
Your answer
School Program or Club *
Your answer
Grade *
Reminder: 1 Year of Wrestling Experience is Required
Weight *
Your answer
Waiver *
I recognize that there are dangers inherent in the sport of wrestling and its training elements, and agree to assume all risks related to my child’s participation. I release, waive, discharge and covenant not to sue the LLWCA, the CVWBC, Conestoga Valley School District, its athletic department and staff, from any and all claims, demands, or course of action whatsoever arising out of or related to any loss, damage, or injury, that may be sustained by my child, or to any property belonging to my child, while participating in this camp, or while in, on or upon the premises where the clinic is being conducted. *By entering my name below I acknowledge that I have read, understand and accept the above contractual agreements.
Your answer
Clinic Option *
Select the appropriate option. Payment will be made after you submit this form using the "Buy Now" button below. No payment is needed for additional family members.
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This form was created inside of Conestoga Valley School District.