MT.

VERNON LIONS/DOMINOS PIZZA OPEN

SUNDAY, JANUARY 29, 2006
TOURNAMENT IS IKWF/USA WRESTLING SANCTIONED
-
MUST PROVIDE CARD
NO cards sold at tournament

LOCATION: Mt. Vernon Twp High School, 320 7th

Mt. Vernon, IL

Entry Fee: $12 Pre-registered - $15 Walk-ins

Fax weights by Friday, January 27th
Fax No: (618) 244-3054 or (618 )242-5922
(Team checks or cash only- No Personal checks) Head coaches are
responsible for payment for all wrestlers on the rosters (NO SHOWS)

WEIGH-INS: Weigh-in will start at

6:00am & end at 8:00am

CHECK-IN: Must be weighed & checked in by 8:00 am

- No exceptions

BRACKETS: 6 & under, 7&8, 9&10, 11&12, 13&14

Brackets will be determined at the conclusion of weigh ins

AWARDS: TROPHIES FOR 1ST – 3RD MEDALS FOR 4TH & 5TH

FOOD: Breakfast, lunch, & snacks items-

Concession available all day

ADMISSIONS: Adults- $3.00 Children- $2.00 3& under free

CONTACT: DEB STRICKLIN: (618) 242-8681 EMAIL: strick4@mvn.net

Scott Tickner: (618) 244-2694 EMAIL:coacht6@sbcglobal.net
Fax No: 618- 244-3054 or 618-242-5922
FORM MUST BE COMPLETED BEFORE WEIGH-INS
PARENT SIGNATURE REQUIRED
Wrestlers
Name: ______________________Record_____________State Qualifier_______

Date of birth__/___/____ Age______Grade_________USA card_____________

Team Name_________________________________________________________

I intended to be legally bound hereby for myself, my heirs, executors and administrators waive and release the Mt. Vernon
High School, Mt. Vernon Lions Wrestling Club, Domino’s Pizza, IKWF, USA wrestling, their agents, representatives,
committees, from any Rights to damage for injuries or losses suffered by me directly or indirectly in training or traveling to or
from competing in, or attending the Mt. Vernon Lions/Dominos Pizza Open Tournament.

Parents/Legal Guardian
Signature________________________________________________Date________________________