Registration

BEST of the WEST Submission Grappling Championship Registration Form

Submission Grappling Saturday, July 23rd, 2011

Location
Long Beach Convention Center, Long Beach, CA. USA.

Pre-Registration ends Wednesday, July 20th, 2011. Domestic mailed registration must be postmarked by Monday, July 18th, 2011.

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

2: Proceed with online registration and pay at door (Extra $15 at door processing fee).

3: Complete Registration Form and Mail with check or money order to:
World Grappling Games
5402 Commercial Lane
Huntington Beach, CA 92649

4: Register at weigh-ins or at door and pay $20 late registration fee

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: