Registration

8th BEST of the WEST Submission Grappling Championship Registration Form

BJJ on Friday, September 28th and Submission Grappling on Saturday, September 29th, 2012

Location
Las Vegas Convention Center, Las Vegas, Nevada.

Pre-Registration ends Wednesday, September 26th, 2012. Domestic mailed registration must be postmarked by Saturday, September 22nd, 2012.

2 Registration options:
1: Proceed with online registration and pay by Credit Card or Pay Pal Now

2: Complete Registration Form and Mail with check or money order to:
GT Association
5402 Commercial Lane
Huntington Beach, CA 92649

Contestant Contact Info
First Name:
Last Name:
Email Address:
Address:
City:
State:
Zip/Postal Code:
Country:
Phone Number:
Cell Phone Number:
Payment Information
Payment Method:

Name on Credit Card
(If paying by Card):
Emergency Contact Name
Emergency Contact Name:
Emergency Phone Number:
Tournament Division Options
Gender:
Age:      Weight: lbs.
Judo Belt:
Wrestling:
BJJ Belt:
Grappling Level:
Pankration Level:
Academy Information
Academy Name:
Academy Phone Number:
Instructor Name:
Division Sign up
Event Selection:
Division:
Disclaimer and Signatures
I Agree
Signature (REQUIRED FIELD Enter your name or if you are under 18 Parent or Guardian must enter theirs.):      Date: