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Chartiers Valley Wrestling
Presents Flowrestling’s
“Youth Coach of the Century”
MIKE KRAUSE
Chartiers Valley High School
Friday June 12th: 4:00-8:30
Saturday June 13th: 10-2:30
Sunday June 14th: 10-2:30
*Each session will include a 45-minute break; wrestlers
must bring their own lunch/snacks.
K-12 Wrestling Camp!! Only $125
per wrestler, or $110 for
registration received before
Memorial Day!! Pre-registration
includes free camp T-shirt.
*For Team, Club, Family, or other financial
considerations, please contact the camp director directly
via phone or email.
Digitally signed by Pennsylvania Youth Wrestling
DN: cn=Pennsylvania Youth Wrestling, o=Pennsylvani Youth
Wrestling, ou=PYW, [email protected], c=US
Date: 2015.04.22 09:14:11 -04'00'
ONLINE REGISTRATION (Click Here)
(Detach Here)
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Please send this form with payment (Checks Payable to “Chartiers Valley Wrestling”) to: Bill Evans / Mike Krause Camp /
341 Gregg Street / Carnegie, PA 15106 - For online forms and registration options, please visit www.pywrestling.com
Wrestler Name_____________________________________ Age____ Grade_____ Weight____________
School District_________________________ T-Shirt Size: YS YM YL AS AM AL AXL
Parent(s) Name(s)_________________________________________ Phone #_______________________
Email Address(es)_______________________________________________________________________
Medical Conditions / Medications___________________________________________________________
Liability release: I, the undersigned, individually and as a parent/guardian of the above listed athlete(s), a minor, ask that he/she be admitted to
participate in the wrestling camp sponsored by The Chartiers Valley Youth and Varsity Wrestling Boosters. I do hereby agree to release, discharge and
hold harmless all parties involved, their owners, agents, Mike Krause, The Chartiers Valley Youth and Varsity Wrestling Boosters, and employees from all
liabilities, damages, claims or demands whatsoever on account of any injury or accident involving the said minor arising out of the minor’s attendance at
the camp or in the course of competition and/or activities held in connection with the camp activities. I also give permission for my child to be
photographed in relations that the photographs may be used to promote the Mike Krause Camp.
Parent/Guardian Signature_______________________________________
Camp Director – Bill Evans
[email protected]
Date_____________
412.726.6239