Name *

First Name

Last Name

Phone

(###)

###

####

Are you and your group able to meet the minimum seminar fee of $XXX? *

Yes

No

Unsure

What are the ages and experience levels of participants? *

Select all that apply

Kids (Under 12)

Teens (13-17)

Adults (18+)

Beginners

Intermediate

Advanced/Competitive

Does your gym have the necessary equipment for training?

Check all that apply

Mats

Training Jackets/Gi

Wrestling Shoes