Personal Information

Name:                   First       Last                  Birthday (mm/dd/yy)

Street Address                 

                 City                 State IL WI   Zip

Valid Email address                 Home phone number             

Emergency contact                  Emergency contact number  

School or Club                                      Grade:  1 2 3 4 5 6 7 8 9 10 11 12

In which program are you interested in joining?  PLEASE SELECT YOUR CHOICE Fall Session Grades 7-12 ($250) Fall Session Grades K-6 ($175)

Wrestling History

Years of Experience                   Current Weight Wrestled                 Approximate natural weight  

Current Record:               Wins   Losses

Current Season Tournament Finishes:             Tournament                                        Place

                                                                                      1st 2nd 3rd 4th 5th 6th 7th 8th

                                                                                      1st 2nd 3rd 4th 5th 6th 7th 8th

                                                                                      1st 2nd 3rd 4th 5th 6th 7th 8th

                                                                                      1st 2nd 3rd 4th 5th 6th 7th 8th

Best Post Season Finishes                      Tournament            Year                Organization      Place

                                                                REGIONALS             2007 2006 2005 2004          IHSA WIAA IESA IKWF       1st 2nd 3rd 4th 5th 6th 7th 8th

                                                                SECTIONALS           2007 2006 2005 2004          IHSA WIAA IESA IKWF       1st 2nd 3rd 4th 5th 6th 7th 8th

                                                                STATE                     2007 2006 2005 2004          IHSA WIAA IESA IKWF       1st 2nd 3rd 4th 5th 6th 7th 8th

Please list all Freestyle or Greco accomplishments:

Please list any other significant wrestling accomplishments:

USA Wrestling Card #

*if you do not yet have a card, you must obtain one before the first day of practice.  USA Cards expire 8/31 annually

Please list all physical conditions of which ISI needs to be aware.  (allergies, illnesses, heart conditions)

Please review your application before submitting.

Please allow 2-3 Business days to receive confirmation of receipt of your application.