*This form must be received by May 1, 2015 along with the non-refundable fee* Name___________________________________ Phone Number ( )____________________ Address_________________________________ City,State,ZIP____________________________ Grade Fall 2015__________Weight___________ School__________________________________ Name of Guardian_________________________ Email___________________________________ Emergency Phone No.( )_______________ T-Shirt Size ___S ___M ___L ___XL ___XXL Resident: ___Wrestler $395 ____Coach $295 (price includes lodging and meals for residents) Commuter: ___Wrestler $235 ____Coach $135 (price does NOT included lodging or meals) ___Commuter meal ticket is $85 additional (optional) _____ I am enclosing my $100 non-refundable deposit and understand that I still owe the remaining balance when camp begins. ALL RESULTS Wrestling Camp c/o John Gannon 586 Bristol Court Clarksville, TN 37043 Pre-Registration Form 14th ANNUAL ALL RESULTS WRESTLING CAMP featuring… Zeke Jones, Greg Strobel, Brian Smith and Duane Goldman June 6 – 10, 2015 _____I am enclosing the full fee for the camp. (If you do not reserve your spot by sending in at least $100 by May 1 you may still participate in the camp by paying an additional $25 late fee, room permitting we will take a maximum of 175 wrestlers.) Only those wrestlers sending in their deposits will receive a camp t-shirt. Coaches receive a $50 discount if they bring 10 wrestlers or a $100 discount if they bring 15 or more wrestlers. A $25 late fee applies to coaches and wrestlers after May 1. We will take a maximum of 175 wrestlers, so register early to get in. Mail this form with the non-refundable fee to: ALL RESULTS Wrestling Camp c/o John Gannon 586 Bristol Court Clarksville, TN 37043 Make checks payable to ALL RESULTS WC Attitude is Contagious Sponsored by: The Leaf-Chronicle Outback Steakhouse Wingate Inn Coca-Cola/Dr. Pepper of Clarksville, TN FedEx Office Wendy's of Clarksville APSU ROTC Camp Schedule June 6 – 10, 2015 FIRST DAY: 10:00 AM APPROX REGISTRATION/1st SESSION DAILY SCHEDULE: 3 TWO HOUR SESSIONS LAST DAY: 9:00 AM-11:00 AM LAST SESSION Complete schedule and information will be mailed upon receiving non-refundable deposit. The camp will be held at Austin Peay State University's Memorial Health Building "The Red Barn" in Clarksville, TN (45 miles northwest of Nashville). The camp is open to any and all participants, including, but not limited to, high school and middle school wrestlers and coaches. If you are in middle school or younger, you must have basic beginner knowledge of wrestling. There will be a takedown tournament during the camp. It will provide campers with both the opportunity to begin working on some of the technique they've learned and a setting outside of drilling/practicing in which to work. There will also be live dual format wrestling. Where do you want to be standing in February? Clinicians Zeke Jones College Career Record of 134 wins at ASU Voted "Most Technical Wrestler in the World" by FILA 1990 NCAA Runner-Up 3x All American 3x Pac 10 Champion 4x World Cup Gold Medalist 6x National Champion 1991 World Champion 1992 US Olympic Silver Medalist 2000 US Olympic Coaching Staff 2001 World Team Coach 2004 US Olympic Head Coach 1997-2005, Asst Head Coach at West Virginia Univ. 2005-2008, Head Coach at University of Pennsylvania 2008-Present, U.S. National Freestyle Head Coach Brian Smith College Career Record of 84 wins at Michigan State Most Outstanding Wrestler – Senior year at MSU 3x All-Big Ten Wrestler Coached 13 All-Americans Coached 3 NCAA Champions Finished #3 in NCAA 2007 2007 Dan Gable Coach of the Year 1998-Present, Head Coach at University of Missouri Greg Strobel College Career Record of 126-8-1 at OSU 2x NCAA Champion 1973 NCAA Championships Outstanding Wrestler Undefeated in final two seasons at OSU 1996 & 2000 USA Olympic Coach 1994 USA Goodwill Games Coach 1999 USA World Team Coach Former USA National Team Coach Former Director for USA Wrestling 2012 National Wresting Hall of Fame 1995-2008, Head Coach at Lehigh University 2008-Present, AD at Lehigh University Duane Goldman College Career Record of 132-10 at Iowa 4x All American 4x Big Ten Champion 4x NCAA Finalist NCAA Champion 1986 1992-Present, Head Coach at Indiana University ******There may be more Clinician(s) added****** Parent Release and Indemnity Agreement To: ALL RESULTS WRESTLING CAMP We (or I) hereby request that you accept the application of ________________________ in the 2015 ALL RESULTS Wrestling Camp during the dates set forth in this application, we (or I) hereby release APSU, CMCSS, their employees, and all persons involve in the ALL RESULTS Wrestling Camp from all claims on account of any injury that may be sustained by our (or my) child while attending the 2015 ALL RESULTS Wrestling Camp; and we (or I) agree to indemnify the parties mentioned above for any claim which may hereafter be presented by our (or my) child as a result of any such injury. Date__________________________________ Parent’s Signature: _______________________________________________ Phone ( )__________________________ Mail with appropriate non-refundable fee to: ALL RESULTS Wrestling Camp c/o John Gannon 586 Bristol Court Clarksville, TN 37043 Make checks payable to ALL RESULTS WC For More information call or email: John Gannon work 931.552.0110 or 1.800.270.0110 home 931.552.4691 email [email protected]
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